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城市化对心境障碍的影响:最新证据的更新。

The impact of urbanization on mood disorders: an update of recent evidence.

机构信息

Deakin University, Food and Mood Centre.

Deakin University, IMPACT SRC, School of Medicine, Geelong.

出版信息

Curr Opin Psychiatry. 2019 May;32(3):198-203. doi: 10.1097/YCO.0000000000000487.

Abstract

PURPOSE OF REVIEW

Mood disorders are highly prevalent and represent a leading cause of global disability. Urbanization holds great public health implications spanning various environmental, lifestyle behavioural, economic and social domains. Underlying risk factors for mood disorders are heterogeneous but the psychiatric literature has extended beyond individual-level risk, to account for population-level environment and social-related precursors to mental ill health. This review summarizes recent studies published since 2017 examining the impact of urbanization and associated environmental, social and lifestyle risks for mood disorders, specifically depression.

RECENT FINDINGS

All identified studies examined depression or subclinical mood-related symptomatology. Recent evidence suggests individuals residing in urban areas experience increased risk of depression. Mechanistic pathways include increased exposure to noise, light and air pollution, poor quality housing, reduced diet quality, physical inactivity, economic strain and diminished social networks. The role of the gut microbiome in the development of mood disorders represents a novel research domain expected to hold potential for the psychiatric and environmental field. Further research is needed to extrapolate the relationship between increased sedentary lifestyles and technology use and depression in urban societies.

SUMMARY

Recent evidence highlights the complexity and reciprocity of underlying driving factors in the relationship between urbanization and mood disorders. Future epidemiological research should continue to untangle such complexity. There was a dearth of evidence relating to urbanization and mood disorders other than depression. Future research should identify the unique experiences of vulnerable subgroups who experience disproportionate increased risk of adverse health experiences associated with urbanization.

摘要

综述目的

情绪障碍的发病率很高,是全球残疾的主要原因之一。城市化对各种环境、生活方式行为、经济和社会领域都有重大的公共卫生影响。情绪障碍的潜在风险因素具有异质性,但精神科文献已经超越了个体风险因素,考虑到与人口环境和社会相关的心理健康不良的前兆。本综述总结了自 2017 年以来发表的最新研究,这些研究检查了城市化以及相关的环境、社会和生活方式风险因素对情绪障碍(特别是抑郁症)的影响。

最近的发现

所有确定的研究都检查了抑郁症或亚临床与情绪相关的症状。最近的证据表明,居住在城市地区的人患抑郁症的风险增加。其机制途径包括更多地暴露在噪音、光和空气污染、住房质量差、饮食质量降低、缺乏身体活动、经济压力和社交网络减少。肠道微生物组在情绪障碍发展中的作用代表了一个新的研究领域,预计对精神科和环境领域有潜在的作用。需要进一步的研究来推断城市社会中增加的久坐生活方式和技术使用与抑郁症之间的关系。

总结

最近的证据强调了城市化和情绪障碍之间关系中潜在驱动因素的复杂性和相互关系。未来的流行病学研究应继续解开这种复杂性。与城市化和情绪障碍(除抑郁症外)相关的证据很少。未来的研究应确定易受伤害的亚组的独特经历,这些亚组与城市化相关的不良健康体验的不成比例的风险增加有关。

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