Department of Psychiatry and Psychotherapy II, University of Ulm at Bezirkskrankenhaus Günzburg, Günzburg, Germany,
Soc Psychiatry Psychiatr Epidemiol. 2013 Nov;48(11):1797-808. doi: 10.1007/s00127-013-0667-1. Epub 2013 Mar 5.
Neighbourhood characteristics are known to be associated with higher rates of hospital admission for psychiatric disorders.
An ecological study with aggregated data was carried out. All cases for schizophrenia and depression in the 42 city districts of Augsburg were identified over a 4-year-period (2006-2009) and neighbourhood variables were obtained. Negative binomial regression adjusted the effects for year of admission and accommodation in inpatient centres.
There was significant association of high unemployment rate, low proportion of working population and high population density with higher rates of admission for schizophrenia. An increase of 1 % in unemployment rate [incidence rate ration (IRR) 1.0451, 95 % CI 1.0175-1.0734] was associated with 5 % raise of admission rates for schizophrenia and an increase of 1 % in working population (IRR 0.9793, 95 % CI 0.9605-0.9985) with a decrease of admission rates by 2 %. High proportion of single households and high percentage of persons eligible for social security increased admission rate for depression. Thus 1 % increase in the proportion of single households (IRR 1.0095, 95 % CI 1.0030-1.0162) and of the proportion of persons eligible for social security (IRR 1.0148, 95 % CI 1.0002-1.0297) both independently were associated with an increased rate of admission for depression of 1 %.
Our analysis demonstrated that measures of social isolation in neighbourhoods and social contacts at work influenced admission for schizophrenia and depression: in neighbourhoods with less social contacts and with a higher proportion of persons not working the admission rates increased. The problem of confounding in ecological studies need to be considered.
已知邻里特征与精神障碍住院率较高有关。
进行了一项具有聚集数据的生态学研究。在 4 年期间（2006-2009 年），确定了奥格斯堡 42 个城市区的所有精神分裂症和抑郁症病例，并获得了邻里变量。负二项回归调整了入院年份和住院中心住宿的影响。
高失业率、低劳动人口比例和高人口密度与精神分裂症入院率较高显著相关。失业率增加 1%[发病率比（IRR）1.0451，95%CI 1.0175-1.0734]与精神分裂症入院率提高 5%相关，劳动人口增加 1%（IRR 0.9793，95%CI 0.9605-0.9985）与入院率降低 2%相关。单身家庭比例高和有资格享受社会保障的人数比例高都会增加抑郁症的入院率。因此，单身家庭比例增加 1%（IRR 1.0095，95%CI 1.0030-1.0162）和有资格享受社会保障的人数比例增加 1%（IRR 1.0148，95%CI 1.0002-1.0297）都与抑郁症入院率增加 1%独立相关。
我们的分析表明，邻里社会隔离和工作中的社会接触措施影响精神分裂症和抑郁症的入院率：在社会接触较少且工作人口比例较高的社区，入院率增加。需要考虑生态学研究中的混杂问题。
