Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Psychol Med. 2012 Jul;42(7):1441-8. doi: 10.1017/S0033291711002613. Epub 2011 Nov 21.
A defining feature of the US economic downturn of 2008-2010 was the alarming rate of home foreclosure. Although a substantial number of US households have experienced foreclosure since 2008, the effects of foreclosure on mental health are unknown. We examined the effects of foreclosure on psychiatric symptomatology in a prospective, population-based community survey.
Data were drawn from the Detroit Neighborhoods and Health Study (DNHS), waves 1 and 2 (2008-2010). A probability sample of predominantly African-American adults in Detroit, Michigan participated (n=1547). We examined the association between home foreclosure between waves 1 and 2 and increases in symptoms of DSM-IV major depression and generalized anxiety disorder (GAD).
The most common reasons for foreclosure were an increase in monthly payments, an increase in non-medical expenses and a reduction in family income. Exposure to foreclosure between waves 1 and 2 predicted symptoms of major depression and GAD at wave 2, controlling for symptoms at wave 1. Even after adjusting for wave 1 symptoms, sociodemographics, lifetime history of psychiatric disorder at wave 1 and exposure to other financial stressors between waves 1 and 2, foreclosure was associated with an increased rate of symptoms of major depression [incidence density ratio (IDR) 2.4, 95% confidence interval (CI) 1.6-3.6] and GAD (IDR 1.9, 95% CI 1.4-2.6).
We provide the first prospective evidence linking foreclosure to the onset of mental health problems. These results, combined with the high rate of home foreclosure since 2008, suggest that the foreclosure crisis may have adverse effects on the mental health of the US population.
2008-2010 年美国经济衰退的一个显著特征是房屋止赎的惊人速度。尽管自 2008 年以来,大量美国家庭经历了止赎,但止赎对心理健康的影响尚不清楚。我们在一项前瞻性、基于人群的社区调查中研究了止赎对精神症状的影响。
数据来自底特律社区与健康研究(DNHS),第 1 波和第 2 波(2008-2010 年)。密歇根州底特律的一个以非洲裔美国成年人为主的概率样本参与了研究(n=1547)。我们研究了第 1 波和第 2 波之间的房屋止赎与 DSM-IV 重性抑郁障碍和广泛性焦虑障碍(GAD)症状增加之间的关联。
止赎的最常见原因是每月付款增加、非医疗费用增加和家庭收入减少。在控制第 1 波症状的情况下,第 1 波和第 2 波之间的止赎暴露预测了第 2 波时的重性抑郁障碍和 GAD 症状。即使在调整了第 1 波症状、社会人口统计学因素、第 1 波时的终生精神障碍史以及第 1 波和第 2 波之间的其他财务压力源后,止赎仍与重性抑郁障碍症状的发生率增加相关[发病率密度比(IDR)2.4,95%置信区间(CI)1.6-3.6]和 GAD(IDR 1.9,95%CI 1.4-2.6)。
我们提供了第一个将止赎与心理健康问题的发生联系起来的前瞻性证据。这些结果,加上自 2008 年以来止赎率居高不下,表明止赎危机可能对美国人口的心理健康产生不利影响。