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首页> 外文期刊>BMC Family Practice >The triple whammy anxiety depression and osteoarthritis in long-term conditions
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The triple whammy anxiety depression and osteoarthritis in long-term conditions

机译：长期状况下的三重重度焦虑抑郁症和骨关节炎

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Improving the management of people with long-term conditions is a key priority of the UK National Health Service. Whilst the coexistence of two or more long-term conditions in one person is increasingly the norm in primary care, guidelines and delivery of care remain focused on single disease management. Anxiety, depression and osteoarthritis are frequently comorbid with other long-term conditions and with each other, with up to 70?% of people with anxiety and depression also suffering from chronic pain. The relationships between anxiety, depression and pain are reciprocal, with each predicting and worsening the outcome of the others. Where these conditions occur in the context of other long-term conditions, further reduction in health-related quality of life and poorer clinical outcomes for all comorbid conditions is observed. It therefore follows that optimising the management of one comorbid condition should confer benefit to the other/s. Yet despite this, anxiety, depression and chronic pain are seldom prioritised by either patient or clinician, therefore remaining under-recognised and under-treated. Case-finding aims to identify and offer timely treatment to individuals with a given disease in a population at risk, therefore offering one possible solution. Yet case-finding is not without its problems, with well-recognised barriers including lack of time, cultural difficulties and inadequate resources and practitioner skills. So whilst the merits of why to actively seek these conditions is clear, how this may be best achieved is not. We explore the potential role of case-finding for anxiety, depression and osteoarthritis-related joint pain in individuals with comorbid long-term conditions, assessing whether adopting an integrated approach to care may allow opportunistic case-finding therefore promoting identification and timely management of these deleterious conditions.
机译：改善长期病患者的管理是英国国家卫生服务的关键优先事项。在一个人中，两种或多种长期疾病的并存越来越成为初级保健的准则，但指导方针和保健提供仍然集中在单一疾病管理上。焦虑，抑郁和骨关节炎经常与其他长期疾病并存，彼此之间并存，多达70％的焦虑和抑郁症患者也患有慢性疼痛。焦虑，抑郁和疼痛之间的关系是相互的，每种关系都预测和恶化其他关系的结果。如果这些状况是在其他长期状况的背景下发生的，则在所有合并症中，与健康相关的生活质量会进一步下降，临床结果会较差。因此可以得出结论，对一种合并症的管理进行优化可以使另一种合并症受益。然而，尽管如此，患者或临床医生仍很少将焦虑，抑郁和慢性疼痛作为优先事项，因此仍未得到充分认识和治疗。病例调查旨在识别高危人群中患有特定疾病的个体并及时提供治疗，从而提供一种可能的解决方案。然而，案例发现并非没有问题，众所周知的障碍包括缺乏时间，文化困难以及资源和从业人员技能不足。因此，尽管积极寻求这些条件的优点显而易见，但如何最好地实现这一点却不是。我们探讨了长期合并症患者中焦虑，抑郁和骨关节炎相关关节痛的病例发现的潜在作用，评估采用综合护理方法是否可能允许机会性病例发现，从而促进对这些病例的识别和及时管理有害的条件。

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