Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Soc Psychiatry Psychiatr Epidemiol. 2011 Nov;46(11):1161-71. doi: 10.1007/s00127-010-0286-z. Epub 2010 Sep 19.
Although greater gender equality at the state-level is associated with fewer depressive symptoms in women after controlling for individual-level confounders, the extent to which state-level women's status is related to psychiatric disorders in women and gender differences in psychopathology has never been examined. We examined these associations in the current report.
We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653), a national probability sample of US adults. Respondents completed structured diagnostic assessments of DSM-IV psychiatric disorders. We used generalized estimating equations to examine associations between four state-level indicators of women's status (political participation, employment/earnings, social/economic autonomy, and reproductive rights) and odds of 12-month mood and anxiety disorders among women. We also tested whether women's status predicted the magnitude of gender differences in psychiatric disorders.
State-level political participation, employment/earnings, and social/economic autonomy were unrelated to odds of 12-month mood and anxiety disorders among women. However, the prevalence of major depression and post-traumatic stress disorder was lower in states where women have greater reproductive rights (OR 0.93-0.95), controlling for individual-level risk factors. None of the women's status indicators predicted gender differences in mood and anxiety disorder prevalence.
State-level women's status was largely unrelated to mood and anxiety disorders in women or to gender differences in these disorders. Investigation of social factors that play a role in shaping the distribution of individual-level risk factors that are associated with gender disparities in psychiatric disorders represents an important avenue for future research.
尽管在控制个体层面混杂因素后，州级性别平等程度与女性抑郁症状减少相关，但州级女性地位与女性精神障碍之间的关系以及精神病理学中的性别差异程度从未被检验过。本研究旨在检验这些关联。
我们使用了来自全国酒精相关状况流行病学调查（National Epidemiologic Survey on Alcohol and Related Conditions，NESARC）的数据（n=34653），这是美国成年人的全国概率样本。受访者完成了DSM-IV 精神障碍的结构化诊断评估。我们使用广义估计方程（generalized estimating equations）来检验四个州级女性地位指标（政治参与、就业/收入、社会/经济自主和生育权利）与女性 12 个月情绪和焦虑障碍之间的关联。我们还检验了女性地位是否预测了精神障碍中性别差异的程度。
州级政治参与、就业/收入和社会/经济自主与女性 12 个月情绪和焦虑障碍的几率无关。然而，在女性拥有更大生育权利的州，主要抑郁症和创伤后应激障碍的患病率较低（OR 0.93-0.95），控制了个体层面的风险因素。女性地位指标都没有预测情绪和焦虑障碍患病率的性别差异。
州级女性地位与女性的情绪和焦虑障碍或这些障碍中的性别差异关系不大。研究在塑造与精神障碍中性别差异相关的个体层面风险因素分布中发挥作用的社会因素，代表了未来研究的一个重要途径。
