Santric-Milicevic Milena, Jankovic Janko, Trajkovic Goran, Terzic-Supic Zorica, Babic Uros, Petrovic Marija
Institute of Social Medicine, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
Institute of Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
Balkan Med J. 2016 Jan;33(1):36-44. doi: 10.5152/balkanmedj.2015.15718. Epub 2016 Jan 1.
The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement.
To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements.
Cross-sectional study.
This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05.
Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51), unemployment (1.36; 1.18-1.56), single status (1.34; 1.23-1.45), and Wealth Index middle class (1.20; 1.08-1.32) or poor (1.33; 1.21-1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89). Single (1.50; 1.26-1.78), unemployed (1.39; 1.07-1.80) and inactive respondents (1.42; 1.10-1.83) had a higher odds of chronic anxiety or depression than married individuals, or those with partner, and employed persons. Those with perceived good health status had lower odds for poor MHI-5, chronic anxiety or depression than those whose general health was average and poor.
Almost half of the population assessed their mental health as poor and 5% had diagnosed chronic anxiety or depression. Multi-sectoral socioeconomic and female-sensitive policies should be wisely tailored to reduce mental health inequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.
精神障碍的全球负担正在上升。在塞尔维亚，焦虑是导致伤残调整生命年的主要原因。塞尔维亚没有针对全体人口的心理健康调查。精神障碍患病率及相关社会经济不平等方面的信息对于改善精神卫生保健很有价值。
探讨塞尔维亚成年人口心理健康障碍的患病率及社会经济不平等情况，并探讨年龄和就业状况在城乡地区是否与心理健康相互作用。
横断面研究。
本研究是对2006年塞尔维亚健康调查的补充分析，该调查采用标准化家庭问卷，对7673个随机抽取的家庭（15563名成年人）的代表性样本进行。应答率为93%。多变量逻辑回归模型突出了5项心理健康量表（MHI-5）以及八个独立变量（年龄、性别、居住类型、婚姻状况和自我感知健康状况、教育程度、就业状况和财富指数）中的慢性焦虑或抑郁的预测因素。描述性统计、卡方分析以及双变量和多变量逻辑回归中的显著性水平设定为p<0.05。
4.9%的受访者存在慢性焦虑或抑郁，47%的受访者MHI-5得分较低。低教育程度（比值比1.32；95%置信区间=1.16-1.51）、失业（1.36；1.18-1.56）、单身状态（1.34；1.23-1.45）以及财富指数为中产阶级（1.20；1.08-1.32）或贫困（1.33；1.21-1.47）与较低的MHI-5得分显著相关。城市地区的失业者MHI-5得分较低的几率高于农村地区的失业者（0.73；0.59-0.89）。单身者（1.50；1.26-1.78）、失业者（1.39；1.07-1.80）和无业受访者（1.42；1.10-1.83）患慢性焦虑或抑郁的几率高于已婚者、有伴侣者以及就业者。自我感知健康状况良好者MHI-5得分较低、患慢性焦虑或抑郁的几率低于一般健康和健康状况较差者。
近一半的人口认为自己的心理健康状况较差，5%的人被诊断患有慢性焦虑或抑郁。应明智地制定多部门社会经济和对女性敏感的政策，以减少因成年人口的年龄、教育、就业、婚姻和财富状况差异导致的心理健康不平等。
