加拿大对心理健康观念的转变。
Changing perceptions of mental health in Canada.
作者信息
Patten Scott B, Williams Jeanne V A, Lavorato Dina H, Fiest Kirsten M, Bulloch Andrew G M, Wang Jianli
机构信息
Professor, Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Member, Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta.
Research Associate, Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
出版信息
Can J Psychiatry. 2014 Nov;59(11):591-6. doi: 10.1177/070674371405901105.
OBJECTIVE
Epidemiologic studies typically assess mental health using diagnostic measures or symptom severity measures. However, perceptions are also important. The objective of our study was to evaluate trends in perceived mental health in Canada during the past 20 years using data collected in a series of surveys.
METHOD
Perceived mental health status, the stressfulness of most days, and perceived general health, have been repeatedly measured in national surveys. In our study, the resulting frequencies and 95% confidence intervals were calculated. Distress was also assessed in the same surveys with the Kessler 6 Psychological Distress Scale, and analyzed using mean scores and frequencies based on cut-points. Data synthesis used forest plots. Time trends were assessed using random effects meta-regression models.
RESULTS
No detectable changes in distress were found. Similarly, self-rated general health remained stable. However, over time, Canadians became slightly more likely to report that their mental health was merely fair or poor. Conversely, they have been progressively less likely to perceive that their lives are quite a bit or extremely stressful.
CONCLUSION
While these observations are ecological, the 2 trends may be related: distressing emotional experiences may increasingly be interpreted as evidence of a disturbance of mental health rather than a reaction to stressful circumstances. These changing perceptions should not be misinterpreted as an epidemic of poor mental health.
目的
流行病学研究通常使用诊断措施或症状严重程度测量来评估心理健康。然而，认知也很重要。我们研究的目的是利用一系列调查收集的数据，评估加拿大过去20年中感知到的心理健康趋势。
方法
在全国性调查中反复测量了感知到的心理健康状况、大多数日子的压力程度以及感知到的总体健康状况。在我们的研究中，计算了所得的频率和95%置信区间。在同一项调查中还使用凯斯勒6项心理困扰量表评估了困扰程度，并根据切点使用平均分和频率进行分析。数据综合使用森林图。使用随机效应元回归模型评估时间趋势。
结果
未发现困扰程度有可检测到的变化。同样，自我评定的总体健康状况保持稳定。然而，随着时间的推移，加拿大人越来越倾向于报告他们的心理健康只是一般或较差。相反，他们越来越不太可能认为自己的生活压力很大或极大。
结论
虽然这些观察是基于群体数据，但这两种趋势可能有关联：令人痛苦的情绪体验可能越来越多地被解释为心理健康障碍的证据，而不是对压力环境的反应。这些不断变化的认知不应被误解为心理健康不佳的流行。
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