Melzer David, Buxton Julian, Villamil Elena
Epidemiology for Policy Group, Dept. of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Soc Psychiatry Psychiatr Epidemiol. 2004 Jan;39(1):33-8. doi: 10.1007/s00127-004-0704-1.
The impact of social transitions that might improve mental health, such as retirement, has attracted limited attention. Adverse occupational conditions and involuntary exit from work are linked to high rates of common mental disorders, but voluntary retirement is associated with improved mental health.
We aimed to estimate the prevalence of common mental disorders around the conventional retirement age and to identify the associated factors that might explain differences in rates.
Data were from the Psychiatric Morbidity Survey of Great Britain (2000), covering a sample of 8,580 respondents aged 16-74 years. Current common mental (neurotic) disorder presence was based on the revised Clinical Interview Schedule.
Prevalence rates for having any common mental disorder in men aged 65-69 years (5%; 95% CI: 2.7-7.3) were dramatically lower than in the agegroup 60-64 years (14.5%; 95 % CI: 10.6-18.5). This pattern applied to individual disorders and to the prevalence of very high symptoms counts. Prevalence rates in women peaked at age 50 and declined thereafter, but no large changes in prevalence are evident around age 60 or 65 years. In men leaving work early (aged 50-64 years), prevalence of common mental disorders remains high until the conventional retirement age. There is little change in exposure to other studied risk factors capable of explaining prevalence reduction, with the exception of decreased economic hardship in the older group.
In the general population aged 50-74 years,there is a dramatic improvement in mental health in men after the conventional retirement age, but not in women. In men who leave work earlier, prevalence remains relatively high until after age 65.
诸如退休等可能改善心理健康的社会转型所产生的影响受到的关注有限。不良的职业条件和非自愿离职与常见精神障碍的高发病率相关,但自愿退休与心理健康状况的改善有关。
我们旨在估计传统退休年龄左右常见精神障碍的患病率,并确定可能解释患病率差异的相关因素。
数据来自英国精神疾病患病率调查(2000年),涵盖8580名年龄在16 - 74岁的受访者样本。当前常见精神(神经症)障碍的存在基于修订后的临床访谈时间表。
65 - 69岁男性中患有任何常见精神障碍的患病率(5%;95%置信区间:2.7 - 7.3)显著低于60 - 64岁年龄组(14.5%;95%置信区间:10.6 - 18.5)。这种模式适用于个体障碍以及非常高症状计数的患病率。女性患病率在50岁时达到峰值,此后下降,但在60岁或65岁左右患病率没有明显大的变化。在提前离职的男性(50 - 64岁)中,常见精神障碍的患病率在达到传统退休年龄之前一直很高。除了老年组经济困难有所减少外,能够解释患病率降低的其他研究风险因素的暴露情况几乎没有变化。
在50 - 74岁的普通人群中,传统退休年龄后男性的心理健康有显著改善,但女性没有。在提前离职的男性中,患病率在65岁之后才相对降低。