Joutsenniemi Kaisla, Martelin Tuija, Martikainen Pekka, Pirkola Sami, Koskinen Seppo
National Public Health Institute (KTL), Department of Health and Functional Capacity, Mannerheimintie 166, 00300 Helsinki, Finland.
J Epidemiol Community Health. 2006 Jun;60(6):468-75. doi: 10.1136/jech.2005.040741.
Non-married persons are known to have poor mental health compared with married persons. Health differences between marital status groups may largely arise from corresponding differences in interpersonal social bonds. However, official marital status mirrors the social reality of persons to a decreasing extent, and living arrangements may be a better measure of social bonds. Little is known about mental health in different living arrangement groups. This study aims to establish the extent and determinants of mental health differences by living arrangement in terms of psychological distress (GHQ) and DSM-IV psychiatric disorders (CIDI).
Data were used from the nationally representative cross sectional health 2000 survey, conducted in 2000-1 in Finland. Altogether 4685 participants (80%) aged 30-64 years were included in these analyses; comprehensive information was available on measures of mental health and living arrangements. Living arrangements were measured as follows: married, cohabiting, living with other(s) than a partner, and living alone.
Compared with the married, persons living alone and those living with other(s) than a partner were approximately twice as likely to have anxiety or depressive disorders. Cohabiters did not differ from the married. In men, psychological distress was similarly associated with living arrangements. Unemployment, lack of social support, and alcohol consumption attenuated the excess psychological distress and psychiatric morbidity of persons living alone and of those living with other(s) than a partner by about 10%-50% each.
Living arrangements are strongly associated with mental health, particularly among men. Information on living arrangements, social support, unemployment, and alcohol use may facilitate early stage recognition of poor mental health in primary health care.
众所周知，与已婚者相比，未婚者的心理健康状况较差。婚姻状况群体之间的健康差异可能很大程度上源于人际社会关系的相应差异。然而，官方婚姻状况对个人社会现实的反映程度在不断降低，生活安排可能是衡量社会关系的更好指标。关于不同生活安排群体的心理健康情况知之甚少。本研究旨在确定根据心理困扰（一般健康问卷，GHQ）和《精神疾病诊断与统计手册》第四版（DSM-IV）精神障碍（复合性国际诊断访谈，CIDI）按生活安排划分的心理健康差异程度及其决定因素。
使用了2000 - 2001年在芬兰进行的具有全国代表性的横断面健康2000调查的数据。这些分析共纳入了4685名年龄在30 - 64岁的参与者（80%）；可获得关于心理健康和生活安排测量的全面信息。生活安排的测量如下：已婚、同居、与伴侣以外的其他人一起生活以及独自生活。
与已婚者相比，独自生活者以及与伴侣以外的其他人一起生活者患焦虑或抑郁障碍的可能性大约是已婚者的两倍。同居者与已婚者没有差异。在男性中，心理困扰与生活安排也有类似的关联。失业、缺乏社会支持和饮酒分别使独自生活者以及与伴侣以外的其他人一起生活者的额外心理困扰和精神疾病发病率降低了约10% - 50%。
生活安排与心理健康密切相关，尤其是在男性中。关于生活安排、社会支持、失业和饮酒的信息可能有助于在初级卫生保健中早期识别心理健康不佳的情况。
