瑞典人群队列研究中青少年确诊抑郁症的社会差异。
Social differences in diagnosed depression among adolescents in a Swedish population based cohort.
机构信息
Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, 113 65, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
出版信息
BMC Psychiatry. 2018 Jul 3;18(1):216. doi: 10.1186/s12888-018-1765-0.
BACKGROUND
Population based research regarding social differences in diagnosed depression in adolescence is sparse. In this study unique material containing in-and outpatient data was used to determine if low social position in childhood increases the risk of diagnosed depression in adolescence. To further examine this association, gender differences and interactions were explored.
METHODS
The study population was extracted from the Stockholm Youth Cohort (SYC), a register based cohort containing psychiatric care for all young people in Stockholm County and information about social position. For the purpose of this study, all in the SYC who turned 13 years old during 2001-2007, in total 169,262 adolescents, were followed up in 2005-2011 for diagnoses of depression until age 18. Associations were estimated with Cox regression models and presented as Hazard Ratios (HR).
RESULTS
The risk of diagnosed depression was higher for adolescents with parents with low education (HR = 1.1, CI = 1.0-1.2) and medium education (HR = 1.1, CI = 1.1-1.2) compared to high as well as for those with lower household income (for example, medium low, HR = 1.2, CI = 1.1-1.3) and for those with parents who received an unemployment benefit (HR = 1.3, CI = 1.2-1.4). No differences were found for those with the lowest household income compared to those with the highest level. Adolescents with parents born outside the Nordic countries had a lower risk of diagnosed depression (HR = 0.7, CI = 0.6-0.7). An interaction effect was found between gender and parental education.
CONCLUSIONS
Social differences were found but the magnitude was modest and gender differences small.
背景
针对青少年人群中，基于人群的诊断性抑郁的社会差异研究较少。在这项研究中，我们使用了独特的包含门诊和住院数据的资料，以确定儿童时期社会地位较低是否会增加青少年时期被诊断为抑郁的风险。为了进一步研究这种关联，我们探讨了性别差异和相互作用。
方法
该研究人群取自斯德哥尔摩青少年队列（SYC），这是一个基于登记的队列，包含了斯德哥尔摩县所有年轻人的精神科护理信息和社会地位信息。为了进行本研究，我们对所有在 2001-2007 年期间年满 13 岁的 SYC 成员进行了随访，这些青少年共有 169262 人，随访至 2005-2011 年，以诊断青少年时期的抑郁障碍，直至 18 岁。使用 Cox 回归模型来估计关联，并以风险比（HR）表示。
结果
与父母受教育程度高的青少年相比，父母受教育程度低（HR=1.1，CI=1.0-1.2）和中等（HR=1.1，CI=1.1-1.2）的青少年，以及家庭收入较低（例如，中等偏下，HR=1.2，CI=1.1-1.3）和父母领取失业救济金（HR=1.3，CI=1.2-1.4）的青少年，被诊断为抑郁的风险更高。与收入最高的青少年相比，收入最低的青少年并没有发现差异。与父母出生在北欧国家的青少年相比，父母出生在北欧以外国家的青少年被诊断为抑郁的风险较低（HR=0.7，CI=0.6-0.7）。还发现了性别和父母教育之间的交互作用效应。
结论
发现了社会差异，但程度较小，且性别差异较小。
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