Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain.
Eur J Public Health. 2013 Feb;23(1):103-8. doi: 10.1093/eurpub/cks035. Epub 2012 Apr 19.
Nearly all European countries have been affected by the economic crisis that began in 2007, but the consequences have been among the worst in Spain. We investigated the associations of the recession on the frequency of mood, anxiety, somatoform, alcohol-related and eating disorders among those visiting Spanish primary care settings.
Primary care physicians selected randomized samples of patients attending primary care centres representing Spain's consulting populations. A total of 7940 patients in 2006-07 and 5876 in 2010-11 were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument to diagnose mental disorders. Multivariate logistic regression models were used to quantify overall changes in the frequency of mental disorders, adjusting for potential socio-demographic differences in consulting populations unrelated to economic factors.
Compared with the pre-crisis period of 2006, the 2010 survey revealed substantial and significant increases in the proportion of patients with mood (19.4% in major depression), anxiety (8.4% in generalized anxiety disorder), somatoform (7.3%) and alcohol-related disorders (4.6% in alcohol dependence), all significant at P < 0.001, but not in eating disorders (0.15%, P = 0.172). Independent of observed risks of unemployment [odds ratio (OR) = 1.72, P < 0.001], we observed a significantly elevated risk of major depression associated with mortgage repayment difficulties (OR = 2.12, P < 0.001) and evictions (OR = 2.95, P < 0.001). About one-third of the overall risk in the consulting population's attendance with mental health disorders could be attributed to the combined risks of household unemployment and mortgage payment difficulties.
Recession has significantly increased the frequency of mental health disorders and alcohol abuse among primary care attendees in Spain, particularly among families experiencing unemployment and mortgage payment difficulties.
几乎所有欧洲国家都受到了始于 2007 年的经济危机的影响，但西班牙受到的影响最为严重。我们研究了经济衰退对西班牙初级保健机构就诊者情绪障碍、焦虑障碍、躯体形式障碍、酒精相关障碍和饮食障碍发生频率的影响。
初级保健医生从代表西班牙就诊人群的初级保健中心中选择随机患者样本。2006-07 年共纳入 7940 例患者，2010-11 年共纳入 5876 例患者，采用初级保健患者心理健康评估量表（PRIME-MD）来诊断精神障碍。采用多变量逻辑回归模型，在调整与经济因素无关的就诊人群中潜在的社会人口学差异后，对精神障碍总体发生率的变化进行量化。
与危机前的 2006 年相比，2010 年的调查显示，心境障碍（重性抑郁障碍的比例为 19.4%）、焦虑障碍（广泛性焦虑障碍的比例为 8.4%）、躯体形式障碍（比例为 7.3%）和酒精相关障碍（酒精依赖的比例为 4.6%）的患者比例显著增加，所有这些差异均具有统计学意义（P<0.001），但饮食障碍的比例没有增加（0.15%，P=0.172）。独立于观察到的失业风险[比值比（OR）=1.72，P<0.001]，我们观察到与抵押贷款还款困难（OR=2.12，P<0.001）和驱逐（OR=2.95，P<0.001）相关的重大抑郁风险显著升高。在就诊人群因心理健康障碍就诊的总风险中，约有三分之一可以归因于家庭失业和抵押贷款还款困难的综合风险。
经济衰退显著增加了西班牙初级保健就诊者的心理健康障碍和酒精滥用的发生频率，尤其是在失业和抵押贷款还款困难的家庭中。
