Department of Psychology, University of Regina, Anxiety and Illness Behaviors Laboratory, 3737 Wascana Parkway, Regina, Saskatchewan, S4S 0A2, Canada.
J Clin Psychiatry. 2010 Sep;71(9):1168-75. doi: 10.4088/JCP.08m04986gry. Epub 2010 Apr 6.
To examine the relationship between household income and psychological distress, suicidal ideation and attempts, and mood, anxiety, and substance use disorders.
Data came from the Collaborative Psychiatric Epidemiology Surveys, a collection of 3 nationally representative surveys of American adults conducted between 2001 and 2003. Psychological distress, suicidal ideation, suicide attempts, and mood, anxiety, and substance use disorders were examined in relation to household income after adjusting for sex, marital status, race, age, and employment status.
Analyses revealed an inverse association between income and psychological distress as measured by the Kessler Psychological Distress Scale, with those in the lowest income quartile demonstrating significantly more distress than any of the remaining 3 income quartiles (P < .05). Subsequent analysis of DSM-IV-diagnosed psychological disorders revealed a similar pattern of results, which were particularly strong for substance use disorders (adjusted odds ratio [AOR] = 1.74; 95% CI, 1.39-2.18), suicidal ideation (AOR = 1.77; 95% CI, 1.46-2.13), and suicide attempts (AOR = 2.15; 95% CI, 1.55-2.98). The association between income and mood and anxiety disorders was less consistent, and the relationship between income and suicidal ideation differed among the 5 race categories (non-Hispanic white, Hispanic, Asian American, black, and other). Non-Hispanic white persons showed a strong, negative relationship between income and suicidal ideation (AOR = 2.15; 95% CI, 1.66-2.80), while the association was considerably weaker or nonexistent for the other races.
Although conclusions cannot be drawn concerning causation, the strength of associations between income, suicidal ideation, suicide attempts, and substance abuse points to the need for secondary prevention strategies among low-income, high-risk populations.
探讨家庭收入与心理困扰、自杀意念和企图以及情绪、焦虑和物质使用障碍之间的关系。
数据来自合作精神流行病学调查，这是一项在 2001 年至 2003 年期间对美国成年人进行的三次全国代表性调查的集合。在调整性别、婚姻状况、种族、年龄和就业状况后，研究了心理困扰、自杀意念、自杀企图以及情绪、焦虑和物质使用障碍与家庭收入的关系。
分析显示，收入与 Kessler 心理困扰量表衡量的心理困扰呈负相关，收入最低的四分之一人群的困扰明显高于其余三个收入四分之一人群（P<.05）。对 DSM-IV 诊断的心理障碍的后续分析显示出类似的结果模式，物质使用障碍的结果尤其强烈（调整后的优势比 [AOR] = 1.74；95%可信区间，1.39-2.18），自杀意念（AOR = 1.77；95%可信区间，1.46-2.13）和自杀企图（AOR = 2.15；95%可信区间，1.55-2.98）。收入与情绪和焦虑障碍之间的关系不太一致，收入与自杀意念之间的关系因 5 个种族类别（非西班牙裔白人、西班牙裔、亚裔美国人、黑人和其他）而异。非西班牙裔白人人群的收入与自杀意念之间存在强烈的负相关关系（AOR = 2.15；95%可信区间，1.66-2.80），而其他种族的关联则较弱或不存在。
尽管不能得出关于因果关系的结论，但收入、自杀意念、自杀企图和物质滥用之间的关联强度表明需要针对低收入、高风险人群制定二级预防策略。
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