德国的精神疾病与城市化
Psychiatric disorders and urbanization in Germany.
作者信息
Dekker Jack, Peen Jaap, Koelen Jurrijn, Smit Filip, Schoevers Robert
机构信息
JellinekMentrum Mental Health Institute, Klaprozenweg 111, P,O, Box 75848, 1070 AV Amsterdam, The Netherlands.
出版信息
BMC Public Health. 2008 Jan 17;8:17. doi: 10.1186/1471-2458-8-17.
BACKGROUND
Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization.
METHODS
The Munich Composite International Diagnostic Interview (M-CIDI) was used to assess the prevalence of mental disorders (DSM-IV) in a representative sample of the German population (N = 4181, age: 18-65). The sample contains five levels of urbanization based on residence location. The epidemiological study was commissioned by the German Ministry of Research, Education and Science (BMBF) and approved by the relevant Institutional Review Board and ethics committee. Written informed consent was obtained for both surveys (core survey and Mental Health Supplement). Subjects did not get any financial compensation for their study participation.
RESULTS
Higher levels of urbanization were linked to higher 12-month prevalence rates for almost all major psychiatric disorders (with the exception of substance abuse and psychotic disorders). The weighted prevalence percentages were highest in the most urbanized category. Alongside urbanization, female gender, lower social class and being unmarried were generally found to be associated with higher levels of psychopathology. The impact of urbanization on mental health was about equal (for almost all major psychiatric disorders) in young people and elderly people, men and women, and in married and single people. Only people from a low social class in the most urbanized settings had more somatoform disorders, and unmarried people in the most urbanized settings had more anxiety disorders.
CONCLUSION
Psychiatric disorders are more prevalent among the inhabitants of more urbanized areas. probably because of environmental stressors.
背景
过去十年的流行病学研究提供了越来越多的证据，表明城市化与精神障碍患病率之间存在关联。我们的目的是在一项全国性的德国人群研究中，检验城市化水平与精神障碍12个月患病率之间的联系，同时控制其他已知的风险因素，如性别、社会阶层、婚姻状况以及这些因素与城市化的交互变量。
方法
采用慕尼黑综合国际诊断访谈（M-CIDI）评估德国代表性人群（N = 4181，年龄：18 - 65岁）中精神障碍（DSM-IV）的患病率。该样本根据居住地点分为五个城市化水平。这项流行病学研究由德国研究、教育和科学部（BMBF）委托进行，并获得了相关机构审查委员会和伦理委员会的批准。两项调查（核心调查和心理健康补充调查）均获得了书面知情同意。受试者参与研究未获得任何经济补偿。
结果
几乎所有主要精神障碍（药物滥用和精神障碍除外）的12个月患病率都与较高的城市化水平相关。加权患病率百分比在城市化程度最高的类别中最高。除城市化外，一般发现女性、社会阶层较低和未婚与较高的精神病理学水平相关。城市化对年轻人和老年人、男性和女性、已婚和单身人群心理健康的影响大致相同（几乎所有主要精神障碍）。只有城市化程度最高地区社会阶层较低的人群有更多的躯体形式障碍，城市化程度最高地区的未婚人群有更多的焦虑障碍。
结论
精神障碍在城市化程度较高地区的居民中更为普遍，可能是由于环境压力源所致。
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