RTI International, Behavioral Health Research Division, Research Triangle Park, NC 27709, Unites States of America.
Epidemiol Psychiatr Sci. 2019 Dec;28(6):682-691. doi: 10.1017/S2045796018000823. Epub 2019 Jan 15.
Residential instability, including transience (i.e. unusually frequent mobility), is associated with higher risk for emotional and behavioural problems in children and young adults. However, most studies have not compared the effect of recent v. more distal moves on mental health or on mental health treatment. This study examined associations between recent (past year) and distal (past 2-4 years) residential transience and past year major depressive episode (MDE) and mental health treatment in a nationally representative sample of US adolescents aged 12-17.
Data are from the 2010-2014 National Surveys on Drug Use and Health (n = ~107 300 adolescents). T-tests were used to examine the prevalence of MDE by number of moves in the past 5 years among a nationally representative sample of adolescents. Additionally, multivariable logistic regression models were used to evaluate the adjusted association between recent (⩾2 moves in the past year) and distal (⩾4 moves in the past 5 years, but no recent transience) and (1) past year MDE and (2) past year mental health treatment among adolescents with MDE.
MDE prevalence increased linearly with number of moves in the past 5 years (p < 0.001). The adjusted odds of MDE were greater among youths with distal transience (adjusted odds ratio (AOR) = 1.25, 95% confidence interval (CI) = 1.09-1.44) and among those with proximal transience (AOR = 1.31, 95% CI = 1.17-1.46), compared with those without transience in the past 5 years. The MDE prevalence did not differ between those with distal and proximal transience (p = 0.163). In youths with past year MDE, the prevalence of past year mental health treatment was greater among those with proximal transience compared with those without transience (AOR = 1.40, 95% CI = 1.15-1.70), but there was no significant difference in treatment among those with distal v. no transience.
Distal and recent transience are associated with past year MDE among adolescents. Adolescents with MDE who had recent transience were more likely to receive past year mental health treatment compared with those without transience. However, those with only distal transience were not more likely to receive treatment. Parents, school officials and health care providers should be aware that residential mobility in the past 5 years may indicate increased odds of depression among adolescents even among adolescents whose housing stability has improved in the past year.
居住不稳定,包括迁徙(即异常频繁的流动),与儿童和青少年的情绪和行为问题的风险增加有关。然而,大多数研究都没有比较近期和更久远的迁移对心理健康或心理健康治疗的影响。本研究在一个具有全国代表性的美国 12-17 岁青少年样本中,研究了过去一年和过去两年至四年的居住变迁与过去一年的主要抑郁发作(MDE)和心理健康治疗之间的关联。
数据来自 2010-2014 年全国毒品使用和健康调查(n=~107300 名青少年)。在具有全国代表性的青少年样本中,采用 t 检验比较过去 5 年中迁移次数与过去一年 MDE 患病率之间的关系。此外,还使用多变量逻辑回归模型评估了过去一年(过去一年中有≥2 次迁移)和过去 5 年(过去 5 年中有≥4 次迁移,但过去一年没有迁移)与(1)过去一年 MDE 和(2)过去一年 MDE 青少年心理健康治疗之间的调整关联。
MDE 的患病率随过去 5 年的迁移次数呈线性增加(p<0.001)。与过去 5 年没有迁移的青少年相比,有迁徙史(调整后的优势比(AOR)=1.25,95%置信区间(CI)=1.09-1.44)和有近期迁徙史(AOR=1.31,95%CI=1.17-1.46)的青少年发生 MDE 的可能性更大。过去一年有迁徙史的青少年和过去一年没有迁徙史的青少年 MDE 患病率没有差异(p=0.163)。在过去一年有 MDE 的青少年中,与过去一年没有迁徙史的青少年相比,过去一年有近期迁徙史的青少年接受心理健康治疗的比例更高(AOR=1.40,95%CI=1.15-1.70),但过去一年有迁徙史和过去一年没有迁徙史的青少年之间的治疗差异没有统计学意义。
近期和过去的迁徙与青少年过去一年的 MDE 有关。过去一年有迁徙史的 MDE 青少年比过去一年没有迁徙史的青少年更有可能接受过去一年的心理健康治疗。然而,只有过去久远的迁徙史的青少年不太可能接受治疗。父母、学校官员和医疗保健提供者应该意识到,过去 5 年内的居住流动可能表明青少年抑郁的几率增加,即使在过去一年住房稳定得到改善的青少年中也是如此。