Thomas H V, Lewis G, Thomas D Rh, Salmon R L, Chalmers R M, Coleman T J, Kench S M, Morgan-Capner P, Meadows D, Sillis M, Softley P
Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Occup Environ Med. 2003 Mar;60(3):181-5; discussion 185-6. doi: 10.1136/oem.60.3.181.
To estimate the prevalence of neurotic symptoms in a sample of British farmers, to investigate whether farming characteristics are associated with psychiatric morbidity, and to test the hypothesis that British farmers have a higher prevalence of depression and thoughts of life not worth living than the British household population.
A total of 425 farmers from Hereford, Norwich, and Preston completed the Revised Clinical Interview Schedule (CIS-R) by computer between March and July 1999. The comparison cohort consisted of 9830 private householders aged 16-64 from the Office of Population Censuses and Surveys National Psychiatric Morbidity Surveys of Great Britain carried out in 1993 in which the CIS-R was administered. All analyses used the commands developed specifically for survey data available in Stata version 6.0.
Taking a threshold of an overall score of 12 or more on the CIS-R, only 6% of farmers reported clinically relevant psychiatric morbidity. Psychiatric morbidity was not significantly associated with farm type or size in this study. Farmers reported a lower prevalence of psychiatric morbidity than the general population but were more likely to report thinking that life is not worth living, particularly after the low prevalence of psychiatric morbidity had been taken into account (odds ratio 2.56, 95% CI 1.39 to 4.69). When restricting the comparison to only rural or semirural householders, this increased risk was even more pronounced (odds ratio 3.26, 95% CI 1.51 to 7.02).
The relation between depression and suicidal ideation seems to be quite different among farmers and the general population and warrants further investigation. We have shown it is possible to measure mental health systematically in a sample of British farmers. This study should be repeated in the aftermath of the foot and mouth crisis.
评估英国农民样本中神经症症状的患病率,调查农业特征是否与精神疾病发病率相关,并检验英国农民比英国家庭人口患抑郁症及觉得生活无意义的想法更为普遍这一假设。
1999年3月至7月期间,来自赫里福德、诺维奇和普雷斯顿的425名农民通过计算机完成了修订版临床访谈问卷(CIS-R)。对照组由9830名年龄在16 - 64岁的私人住户组成,这些数据来自1993年进行的英国人口普查与调查办公室全国精神疾病发病率调查,当时采用了CIS-R。所有分析均使用了专门为Stata 6.0版本中的调查数据开发的命令。
以CIS-R总分12分及以上为临界值,只有6%的农民报告有临床相关的精神疾病发病率。在本研究中,精神疾病发病率与农场类型或规模无显著关联。农民报告的精神疾病发病率低于普通人群,但更有可能报告觉得生活无意义,尤其是在考虑到精神疾病发病率较低的情况后(优势比2.56,95%可信区间1.39至4.69)。当仅将比较范围限制在农村或半农村住户时,这种增加的风险更为明显(优势比3.26,95%可信区间1.51至7.02)。
农民和普通人群中抑郁症与自杀意念之间的关系似乎有很大不同,值得进一步研究。我们已经表明,对英国农民样本进行心理健康系统测量是可行的。口蹄疫危机过后,应该重复这项研究。