Sorbonne Université, Université Pierre et Marie Curie, Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique UMRS 1136, Paris, France.
Population-Based Epidemiological Cohorts Unit, Institut National de la Santé et de la Recherche Médicale UMS 11, Villejuif, France.
Am J Epidemiol. 2018 Feb 1;187(2):260-269. doi: 10.1093/aje/kwx252.
Using data from the nationally representative Consultants des Centres d'Examens de Santé (CONSTANCES) study in France (2012-2014; n = 67,057), we assessed the relationship between intergenerational socioeconomic mobility and adult depression (Center for Epidemiological Studies-Depression Scale scores of ≥16 in men or ≥20 in women) and antidepressant use. Socioeconomic position was ascertained by occupational grade (childhood: maternal and paternal measures prior to age 15 years combined; adulthood: participant's own). We used logistic regression models adjusted for sociodemographic characteristics, parental history of psychiatric disorders and suicide, health behaviors, and chronic health problems. Compared with the reference group (persistently high socioeconomic circumstances), participants in other groups had elevated levels of depression (for upward mobility, multivariate odds ratios (OR) = 1.21; intermediate socioeconomic position, 1.28; downward mobility, 1.66; persistently low socioeconomic position, 1.82). Downward mobility and persistently low socioeconomic position were also associated with elevated odds of antidepressant use (for downward mobility, multivariate OR = 1.24; for persistently low socioeconomic position, 1.36). In supplementary analyses, the association of socioeconomic mobility with depression was stronger in women than in men and among younger participants (aged 18-29 years) than among older participants. Factors that contribute to depression risk and socioeconomic inequalities in this area appeared to be at play already in childhood; this should be acknowledged by clinicians and policymakers.
利用法国全国代表性的顾问 des Centres d'Examens de Santé (CONSTANCES) 研究（2012-2014 年；n=67057）中的数据，我们评估了代际社会经济流动性与成年人抑郁（男性中心血管疾病流行病学研究抑郁量表评分≥16，女性≥20）和抗抑郁药使用之间的关系。社会经济地位通过职业等级确定（童年期：母亲和父亲在 15 岁之前的测量值合并；成年期：参与者自己的测量值）。我们使用逻辑回归模型调整了社会人口统计学特征、父母精神障碍和自杀史、健康行为和慢性健康问题。与参考组（持续高社会经济环境）相比，其他组别的参与者抑郁程度更高（向上流动，多变量优势比（OR）=1.21；中等社会经济地位，1.28；向下流动，1.66；持续低社会经济地位，1.82）。向下流动和持续低社会经济地位也与抗抑郁药使用的几率增加相关（向下流动，多变量 OR=1.24；持续低社会经济地位，1.36）。在补充分析中，社会经济流动性与抑郁的关联在女性中强于男性，在年轻参与者（18-29 岁）中强于年长参与者。导致抑郁风险和该领域社会经济不平等的因素似乎在儿童时期就已经存在；临床医生和政策制定者应该认识到这一点。
