the Ohio State University College of Public Health, Columbus, Ohio, USA.
Cancer. 2010 Mar 1;116(5):1218-25. doi: 10.1002/cncr.24832.
A large body of literature suggests that socioeconomic status (SES) is positively associated with mental and physical health. However, little research has examined the impact of SES on psychological adjustment after a major stressor. The current study examined whether SES (education and financial status) was associated with distress (anxiety and depression) in women diagnosed with ductal carcinoma in situ (DCIS). This study also explored whether social support explained the association between SES and distress and whether social support buffered the impact of low SES on distress.
A total of 487 women with newly diagnosed DCIS were enrolled in the study. Participants completed questions about sociodemographic, psychosocial, and clinical characteristics at the time of enrollment and 9 months after their diagnosis.
Financial status was inversely associated with anxiety and depression at the 9-month follow-up. Financial status also predicted change in anxiety and depression. Women with high financial status reported a decline in anxiety and depression during the study period, whereas women with medium or low financial status reported an increase in anxiety and depression. In addition, the probability of exceeding the screening threshold suggestive of clinical depression increased with decreasing financial status. Education was not associated with anxiety or depression. The presence of social support did not explain the association between financial status and change in distress. Social support did not buffer the effect of low SES on anxiety and depression.
Women with medium or low SES were vulnerable to escalating anxiety and depression after a DCIS diagnosis.
大量文献表明，社会经济地位（SES）与身心健康呈正相关。然而，很少有研究探讨 SES 对重大压力源后心理适应的影响。本研究旨在探讨 SES（教育和经济状况）是否与诊断为导管原位癌（DCIS）的女性的困扰（焦虑和抑郁）相关。本研究还探讨了社会支持是否解释了 SES 与困扰之间的关联，以及社会支持是否缓冲了低 SES 对困扰的影响。
共有 487 名新诊断为 DCIS 的女性参加了这项研究。参与者在入组时和诊断后 9 个月完成了有关社会人口统计学、心理社会和临床特征的问题。
经济状况与 9 个月随访时的焦虑和抑郁呈负相关。经济状况也预测了焦虑和抑郁的变化。经济状况较高的女性在研究期间报告焦虑和抑郁有所下降，而经济状况中等或较低的女性报告焦虑和抑郁有所增加。此外，随着经济状况的下降，筛查提示临床抑郁的可能性增加。教育与焦虑或抑郁无关。社会支持的存在并不能解释经济状况与困扰变化之间的关联。社会支持并不能缓冲低 SES 对焦虑和抑郁的影响。
SES 中等或较低的女性在诊断为 DCIS 后容易出现焦虑和抑郁加剧。
