Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members.

Autor: Vyas KJ; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Fesperman SF; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Nebeker BJ; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Gerard SK; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Boyd ND; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Delaney EM; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Webb-Murphy JA; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400., Johnston SL; Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery, U.S. Navy, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134-6400.
Jazyk: angličtina
Zdroj: Military medicine [Mil Med] 2016 Oct; Vol. 181 (10), pp. 1240-1247.
DOI: 10.7205/MILMED-D-15-00585
Abstrakt: The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.
(Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.)
Databáze: MEDLINE
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