Barbaglia María Gabriela, ten Have Margreet, Dorsselaer Saskia, Alonso Jordi, de Graaf Ron
Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques-IMIM, Barcelona, Spain.
Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
J Epidemiol Community Health. 2015 Jan;69(1):55-62. doi: 10.1136/jech-2014-204184. Epub 2014 Sep 9.
There is increasing interest on whether the current global economic uncertainties have an influence on the population's mental health. In this paper, we examined the association of negative socioeconomic changes, job loss and household income reductions with incident mental disorders. The moderating effect of gender was assessed.
Data come from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a representative population-based, longitudinal study. Individuals with a paid job and without a 12-month mental disorder at baseline were selected and reassessed 3 years later (2007-2009/2010-2012). Substantial household income reductions and not being at a paid job anymore were self-reported at follow-up. Multivariate logistic models were utilised to investigate the association between these negative socioeconomic changes and the incidence of mood, anxiety and substance use Diagnostic and Statistical Manual-IV disorders assessed by the Composite International Diagnostic Interview 3.0.
After 3 years, 6% had lost their job, 11% had a substantial household income reduction and 12.2% had developed a mental disorder. Household income reductions increased the risk of any mental disorder (aOR=1.77), particularly the risk of mood (aOR=2.24). Job loss increased the risk of mood disorders (aOR=2.02). Gender modified the relationship: job loss increased the risk of any mental disorder among men (aOR=3.04) and household income reductions did so among women (aOR=2.32).
Negative socioeconomic changes occurring within a short time period significantly increased the risk of incident mental disorders, particularly of mood disorders. Effective interventions to alleviate the public mental health impact of negative socioeconomic changes on men and women are needed.
当前全球经济不确定性是否会对人群心理健康产生影响，这一问题正引发越来越多的关注。在本文中，我们研究了负面社会经济变化、失业和家庭收入减少与新发精神障碍之间的关联。同时评估了性别在其中的调节作用。
数据来自荷兰心理健康调查与发病率研究-2（NEMESIS-2），这是一项具有代表性的基于人群的纵向研究。选取基线时拥有带薪工作且无12个月精神障碍病史的个体，3年后（2007 - 2009/2010 - 2012）进行重新评估。随访时通过自我报告获取家庭收入大幅减少和不再拥有带薪工作的情况。运用多变量逻辑模型研究这些负面社会经济变化与通过综合国际诊断访谈3.0评估的心境、焦虑和物质使用障碍（依据《精神疾病诊断与统计手册》第四版）发病率之间的关联。
3年后，6%的人失去了工作，11%的家庭收入大幅减少，12.2%的人患上了精神障碍。家庭收入减少会增加患任何精神障碍的风险（调整后比值比[aOR]=1.77），尤其是心境障碍的风险（aOR=2.24）。失业会增加心境障碍的风险（aOR=2.02）。性别起到了调节作用：失业会增加男性患任何精神障碍的风险（aOR=3.04），而家庭收入减少会增加女性患任何精神障碍的风险（aOR=2.32）。
短时间内发生的负面社会经济变化会显著增加新发精神障碍的风险，尤其是心境障碍。需要采取有效的干预措施来减轻负面社会经济变化对男性和女性心理健康的影响。
