Breslau Joshua, Borges Guilherme, Tancredi Daniel, Saito Naomi, Kravitz Richard, Hinton Ladson, Vega William, Medina-Mora Maria Elena, Aguilar-Gaxiola Sergio
Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
Arch Gen Psychiatry. 2011 Apr;68(4):428-33. doi: 10.1001/archgenpsychiatry.2011.21.
Migration is suspected to increase risk for depressive and anxiety disorders.
To test the hypothesized increase in risk for depressive and anxiety disorders after arrival in the United States among Mexican migrants.
We combined data from surveys conducted separately in Mexico and the United States that used the same diagnostic interview. Discrete time survival models were specified to estimate the relative odds of first onset of depressive disorders (major depressive episode and dysthymia) and anxiety disorders (generalized anxiety disorder, social phobia, panic disorder, and posttraumatic stress disorder) among migrants after their arrival in the United States compared with nonmigrant Mexicans who have a migrant in their immediate family.
Population surveys in the United States and Mexico.
Two thousand five hundred nineteen nonmigrant family members of migrants in Mexico and 554 Mexican migrants in the United States.
First onset of any depressive or anxiety disorder.
After arrival in the United States, migrants had a significantly higher risk for first onset of any depressive or anxiety disorder than did nonmigrant family members of migrants in Mexico (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). Associations between migration and disorder varied across birth cohorts. Elevated risk among migrants relative to nonmigrants was restricted to the 2 younger cohorts (those aged 18-25 or 26-35 years at interview). In the most recent birth cohort, the association between migration and first onset of any depressive or anxiety disorder was particularly strong (odds ratio, 3.89; 95% confidence interval, 2.74-5.53).
This is, to our knowledge, the first study to compare risk for first onset of psychiatric disorder between representative samples of migrants in the United States and nonmigrants in Mexico. The findings are consistent with the hypothesized adverse effect of migration from Mexico to the United States on the mental health of migrants, but only among migrants in recent birth cohorts.
人们怀疑移民会增加患抑郁症和焦虑症的风险。
检验墨西哥移民抵达美国后患抑郁症和焦虑症风险增加这一假设。
我们合并了在墨西哥和美国分别进行的调查数据，这些调查使用了相同的诊断访谈。设定离散时间生存模型，以估计移民抵达美国后首次出现抑郁症（重度抑郁发作和心境恶劣障碍）和焦虑症（广泛性焦虑症、社交恐惧症、恐慌症和创伤后应激障碍）的相对几率，并与直系亲属中有移民的非移民墨西哥人进行比较。
美国和墨西哥的人口调查。
墨西哥2519名移民的非移民家庭成员以及美国554名墨西哥移民。
首次出现任何抑郁症或焦虑症。
抵达美国后，移民首次出现任何抑郁症或焦虑症的风险显著高于墨西哥移民的非移民家庭成员（优势比为1.42；95%置信区间为1.04 - 1.94）。移民与疾病之间的关联因出生队列而异。移民相对于非移民的风险升高仅限于两个较年轻的队列（访谈时年龄在18 - 25岁或26 - 35岁的人群）。在最近的出生队列中，移民与首次出现任何抑郁症或焦虑症之间的关联尤为强烈（优势比为3.89；95%置信区间为2.74 - 5.53）。
据我们所知，这是第一项比较美国移民代表性样本与墨西哥非移民首次出现精神疾病风险的研究。研究结果与从墨西哥移民到美国对移民心理健康产生不良影响的假设一致，但仅适用于最近出生队列中的移民。
