Sareen Jitender, Afifi Tracie O, McMillan Katherine A, Asmundson Gordon J G
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Arch Gen Psychiatry. 2011 Apr;68(4):419-27. doi: 10.1001/archgenpsychiatry.2011.15.
There has been increasing concern about the impact of the global economic recession on mental health. To date, findings on the relationship between income and mental illness have been mixed. Some studies have found that lower income is associated with mental illness, while other studies have not found this relationship.
To examine the relationship between income, mental disorders, and suicide attempts.
Prospective, longitudinal, nationally representative survey.
United States general population.
A total of 34,653 noninstitutionalized adults (aged ≥20 years) interviewed at 2 time points 3 years apart.
Lifetime DSM-IV Axis I and Axis II mental disorders and lifetime suicide attempts, as well as incident mental disorders and change in income during the follow-up period.
After adjusting for potential confounders, the presence of most of the lifetime Axis I and Axis II mental disorders was associated with lower levels of income. Participants with household income of less than $20,000 per year were at increased risk of incident mood disorders during the 3-year follow-up period in comparison with those with income of $70,000 or more per year. A decrease in household income during the 2 time points was also associated with an increased risk of incident mood, anxiety, or substance use disorders (adjusted odds ratio, 1.30; 99% confidence interval, 1.06-1.60) in comparison with respondents with no change in income. Baseline presence of mental disorders did not increase the risk of change in personal or household income in the follow-up period.
Low levels of household income are associated with several lifetime mental disorders and suicide attempts, and a reduction in household income is associated with increased risk for incident mental disorders. Policymakers need to consider optimal methods of intervention for mental disorders and suicidal behavior among low-income individuals.
全球经济衰退对心理健康的影响日益受到关注。迄今为止，关于收入与精神疾病之间关系的研究结果不一。一些研究发现低收入与精神疾病有关，而其他研究则未发现这种关系。
研究收入、精神障碍与自杀未遂之间的关系。
前瞻性、纵向、具有全国代表性的调查。
美国普通人群。
共有34653名非机构化成年人（年龄≥20岁），在相隔3年的两个时间点接受访谈。
终生的《精神疾病诊断与统计手册》第四版轴I和轴II精神障碍以及终生自杀未遂情况，以及随访期间的新发精神障碍和收入变化。
在对潜在混杂因素进行调整后，大多数终生轴I和轴II精神障碍的存在与较低的收入水平相关。与年收入7万美元或以上的参与者相比，家庭年收入低于2万美元的参与者在3年随访期间发生情绪障碍的风险增加。与收入无变化的受访者相比，两个时间点之间家庭收入的减少也与发生情绪、焦虑或物质使用障碍的风险增加相关（调整后的优势比为1.30；99%置信区间为1.06 - 1.60）。基线时存在精神障碍并未增加随访期间个人或家庭收入变化的风险。
家庭收入水平低与多种终生精神障碍和自杀未遂有关，家庭收入减少与新发精神障碍的风险增加有关。政策制定者需要考虑针对低收入个体精神障碍和自杀行为的最佳干预方法。
