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如何解释家庭贫困与儿童抑郁症状之间的关系?

What explains the relation between family poverty and childhood depressive symptoms?

作者信息

Tracy Melissa, Zimmerman Frederick J, Galea Sandro, McCauley Elizabeth, Stoep Ann Vander

机构信息

Department of Epidemiology, University of Michigan, School of Public Health, 109 Observatory Street, Ann Arbor, MI 48109, United States.

出版信息

J Psychiatr Res. 2008 Oct;42(14):1163-75. doi: 10.1016/j.jpsychires.2008.01.011. Epub 2008 Mar 4.

Abstract

The relation between low socioeconomic status (SES) and depression has been well documented in adult populations. A number of studies suggest that family SES may be associated with depression among children and adolescents as well, although the evidence is mixed. We assessed the relation between family income and depressive symptoms among 457 children aged 11-13 years and examined pathways that may explain this relation. In-person interviews of children and their caregivers were conducted, including assessment of family income and administration of the Computer-based Diagnostic Interview Schedule for Children (C-DISC). Family income was significantly associated with depressive symptoms, with children in the lowest income group (<$35,000) reporting a mean of 8.12 symptoms compared to 6.27 symptoms in the middle income group ($35,000-$74,999) and 5.13 symptoms in the highest income group (> or = $75,000; p<0.001). Controlling for the number of stressful life events experienced in the past 6 months attenuated the effect of low family income on depressive symptoms by 28%. Indicators of the family environment explained 45% and neighborhood median household income and aggravated assault rate explained 12% of the relation. The family environment, including parental divorce or separation and perceived parental support, appears to explain most of the relation between low family income and childhood depressive symptoms. Further exploration of the pathways between family SES and depression may suggest potential interventions to reduce the occurrence and persistence of depressive symptoms in children.

摘要

社会经济地位低下(SES)与成年人抑郁症之间的关系已有充分记录。多项研究表明,家庭SES可能也与儿童和青少年的抑郁症有关,尽管证据并不一致。我们评估了457名11至13岁儿童的家庭收入与抑郁症状之间的关系,并研究了可能解释这种关系的途径。对儿童及其照顾者进行了面对面访谈,包括家庭收入评估和使用基于计算机的儿童诊断访谈量表(C-DISC)。家庭收入与抑郁症状显著相关,收入最低组(<$35,000)的儿童平均报告有8.12个症状,而中等收入组($35,000 - $74,999)为6.27个症状,最高收入组(≥$75,000;p<0.001)为5.13个症状。控制过去6个月经历的压力性生活事件数量后,低家庭收入对抑郁症状的影响减弱了28%。家庭环境指标解释了这种关系的45%,邻里家庭收入中位数和严重攻击率解释了12%。家庭环境,包括父母离婚或分居以及感知到的父母支持,似乎解释了低家庭收入与儿童抑郁症状之间的大部分关系。进一步探索家庭SES与抑郁症之间的途径可能会提示潜在的干预措施,以减少儿童抑郁症状的发生和持续。

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