Remes Olivia, Wainwright Nicholas W J, Surtees Paul, Lafortune Louise, Khaw Kay-Tee, Brayne Carol
Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
BMJ Open. 2018 Apr 23;8(4):e018501. doi: 10.1136/bmjopen-2017-018501.
Many patients receiving medical treatment for anxiety relapse or do not improve. Research has therefore been turning to coping mechanisms as a way to decrease anxiety rates. Previously, we showed that living in a deprived area significantly increases the risk of anxiety in women, but not in men. The objective of this study is to assess whether sense of coherence (coping mechanism) buffers the influence of area deprivation on women's risk of generalised anxiety disorder using data from the European Prospective Investigation of Cancer-Norfolk.
Large, population study.
UK population-based cohort.
30 445 people over the age of 40 years were recruited through general practice registers in England. Of these, 20 919 completed a structured health and lifestyle questionnaire used to assess generalised anxiety disorder and sense of coherence. Area deprivation was measured using 1991 Census data, and sense of coherence and anxiety were examined in 1996-2000. 10 183 women had data on all variables.
Past-year generalised anxiety disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
In this study, 2.6% (260/10 183) of women had generalised anxiety disorder. In those with a strong sense of coherence, area deprivation was not significantly associated with anxiety (OR 1.29, 95% CI 0.77 to 2.17). However, among women with a weak sense of coherence, those living in deprived areas were almost twice as likely to have generalised anxiety disorder compared with those living in more affluent areas (OR 1.99, 95% CI 1.37 to 2.91).
The number of women living in deprived conditions is large worldwide, and significant numbers are affected by generalised anxiety disorder. Sense of coherence moderates the association between area deprivation and anxiety in women; therefore, interventions targeting coping mechanisms may need to be considered for people with anxiety.
许多接受焦虑症治疗的患者会复发或病情不见好转。因此，研究开始转向应对机制，将其作为降低焦虑率的一种方法。此前，我们发现生活在贫困地区会显著增加女性患焦虑症的风险，但对男性则不然。本研究的目的是利用欧洲癌症前瞻性调查——诺福克（European Prospective Investigation of Cancer-Norfolk）的数据，评估连贯感（应对机制）是否能缓冲地区贫困对女性患广泛性焦虑症风险的影响。
大型人群研究。
基于英国人群的队列研究。
通过英格兰的全科医生登记册招募了30445名40岁以上的人。其中，20919人完成了一份结构化的健康与生活方式问卷，用于评估广泛性焦虑症和连贯感。使用1991年人口普查数据衡量地区贫困程度，并在1996 - 2000年期间对连贯感和焦虑情况进行调查。10183名女性拥有所有变量的数据。
根据《精神障碍诊断与统计手册》第四版定义的过去一年广泛性焦虑症。
在本研究中，2.6%（260/10183）的女性患有广泛性焦虑症 在连贯感较强的女性中，地区贫困与焦虑症无显著关联（比值比1.29，95%置信区间0.77至2.17）。然而，在连贯感较弱的女性中，生活在贫困地区的女性患广泛性焦虑症的可能性几乎是生活在较富裕地区女性的两倍（比值比1.99，95%置信区间1.37至2.91）。
全球生活在贫困条件下的女性数量众多，且有相当数量的人受到广泛性焦虑症的影响。连贯感可调节地区贫困与女性焦虑症之间的关联；因此，对于焦虑症患者，可能需要考虑针对应对机制的干预措施。
