Araya R, Lewis G, Rojas G, Fritsch R
University of Bristol, Division of Psychiatry, Bristol, UK.
J Epidemiol Community Health. 2003 Jul;57(7):501-5. doi: 10.1136/jech.57.7.501.
To assess which indicators of socioeconomic status are associated with an increased prevalence of common mental disorders.
Cross sectional household survey.
Santiago, Chile.
Random sample of adults aged 16-65 residing in private households.
Less education (odds ratio 2.44, 95% confidence intervals 1.50 to 3.97), a recent income decrease (odds ratio 2.14, 1.70 to 2.70), and poor housing (odds ratio 1.53, 1.05 to 2.23), were the only socioeconomic status variables that remained significantly associated with an increased prevalence of common mental disorders after adjustments. The prevalence of common mental disorders was also higher among people with manual unskilled occupations, overcrowded housing, and lower per capita income but these associations disappeared after adjustment for other explanatory and confounding variables.
There is a strong, inverse, and independent association between education and common mental disorders. However, income was not associated with the prevalence of common mental disorders, after adjusting for other socioeconomic variables. Similar results have been found in other Latin American studies but British studies tend to find the opposite, that income but not education is associated with common mental disorders. Understanding the impact of socioeconomic factors on mental health requires research in poor as well as rich countries.
评估哪些社会经济地位指标与常见精神障碍患病率的增加相关。
横断面家庭调查。
智利圣地亚哥。
居住在私人家庭中的16 - 65岁成年人随机样本。
受教育程度较低(优势比2.44,95%置信区间1.50至3.97)、近期收入下降(优势比2.14,1.70至2.70)以及住房条件差(优势比1.53,1.05至2.23),是在调整后仍与常见精神障碍患病率增加显著相关的仅有的社会经济地位变量。常见精神障碍的患病率在从事非熟练体力职业、住房拥挤以及人均收入较低的人群中也较高,但在对其他解释性和混杂变量进行调整后,这些关联消失了。
教育与常见精神障碍之间存在强烈的、反向的且独立的关联。然而,在对其他社会经济变量进行调整后,收入与常见精神障碍的患病率无关。其他拉丁美洲研究也发现了类似结果,但英国研究往往得出相反结论,即收入而非教育与常见精神障碍相关。了解社会经济因素对心理健康的影响需要在贫穷国家和富裕国家都开展研究。