Vancampfort Davy, Koyanagi A, Ward Philip B, Veronese Nicola, Carvalho André F, Solmi Marco, Mugisha James, Rosenbaum Simon, De Hert Marc, Stubbs Brendon
Am J Epidemiol. 2017 Oct 15;186(8):979-989. doi: 10.1093/aje/kwx159.
In this study, we assessed the association of chronic medical conditions and multimorbidity with perceived stress among community-dwelling adults in 44 low- and middle-income countries. Data from the World Health Survey (2002-2004), including 229,293 adults, were analyzed. A perceived stress score (range, 0 (lowest stress)-100 (highest stress)) was computed on the basis of 2 questions from the Perceived Stress Scale. Eleven chronic conditions were assessed. Multivariable linear regression analyses were conducted to explore the associations. All chronic conditions were associated with significantly higher mean perceived stress scores, with the exception of edentulism. The associations were particularly strong for depression (β = 14.71, 95% confidence interval (CI): 13.68, 15.74), visual impairment (β = 10.66, 95% CI: 8.09, 13.23), and schizophrenia (β = 9.98, 95% CI: 7.71, 12.24). Compared with no chronic conditions, the β coefficients for perceived stress with the presence of 1, 2, 3, and ≥4 chronic conditions were 5.58 (95% CI: 4.94, 6.23), 9.58 (95% CI: 8.67, 10.49), 14.15 (95% CI: 12.63, 15.67), and 20.17 (95% CI: 18.29, 22.05), respectively. The associations with perceived stress were significantly stronger among the poorest individuals for arthritis, asthma, diabetes, edentulism, and ≥4 chronic conditions. Our data suggest that a range of chronic conditions and multimorbidity are associated with greatly increased perceived stress among people in low- and middle-income countries, and that the poorest persons may be a particularly vulnerable group.
在本研究中，我们评估了44个低收入和中等收入国家社区居住成年人的慢性疾病和多病共存与感知压力之间的关联。对世界卫生调查（2002 - 2004年）中包括229,293名成年人的数据进行了分析。根据感知压力量表中的2个问题计算出感知压力得分（范围为0（最低压力）至100（最高压力））。评估了11种慢性疾病。进行多变量线性回归分析以探究这些关联。除无牙外，所有慢性疾病均与显著更高的平均感知压力得分相关。抑郁症（β = 14.71，95%置信区间（CI）：13.68，15.74）、视力障碍（β = 10.66，95%CI：8.09，13.23）和精神分裂症（β = 9.98，95%CI：7.71，12.24）的关联尤为强烈。与无慢性疾病相比，患有1种、2种、3种和≥4种慢性疾病时感知压力的β系数分别为5.58（95%CI：4.94，6.23）、9.58（95%CI：8.67，10.49）、14.15（95%CI：12.63，15.67）和20.17（95%CI：18.29，22.05）。在最贫困个体中，关节炎、哮喘、糖尿病、无牙和≥4种慢性疾病与感知压力的关联显著更强。我们的数据表明，一系列慢性疾病和多病共存与低收入和中等收入国家人群中感知压力的大幅增加相关，且最贫困人群可能是特别脆弱的群体。
