Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Faculty of Physical Education and Sport, Charles University, José Martího 31, Prague 6, 162 52, Czech Republic.
Research Institute of Internal and Preventive Medicine, Branch of the Institute of Cytology and Genetics, SB RAS, Prospekt Lavrentyeva 10, 630090, Novosibirsk, Russia; Novosibirsk State Medical University, Borisa Bogatkova 175/1, 630089, Novosibirsk, Russia.
Soc Sci Med. 2019 Sep;237:112454. doi: 10.1016/j.socscimed.2019.112454. Epub 2019 Jul 29.
Two gaps in the literature arise on the relationship between social cohesion and depressive disorders. Firstly, there is a lack of studies comparing countries with diverse communal bonds and population-level differences in depression. Secondly, most work on explanatory mechanisms has overwhelmingly focussed on social network and social support pathways.
We compared the prospective association between perceived neighbourhood social cohesion and depressive symptoms among older adults in England, the Czech Republic, Poland and Russia; and examined whether psychological and health behavioural pathways mediated this association.
Harmonized data on 26,081 adults from the English Longitudinal Study of Ageing (ELSA), and the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) studies were analysed. Prospective associations between perceived neighbourhood social cohesion at baseline and depressive symptoms at follow-up were assessed using multivariable negative binomial regression. The psychological (through control of life, and control at home) and health behavioural (through smoking and drinking) pathways were tested using path analysis.
Low cohesion predicted a higher number of depressive symptoms at follow-up among English (b = 0.106, p = 0.001), Czech (b=0.203, p < 0.001), Polish (0.115, p < 0.001) and Russian adults (b = 0.087, p < 0.001). Indirect effects via psychological mechanisms were strong and explained 64% (Poland), 82% (Russia), 84% (England) and 95% (Czech Republic) of the total indirect effects from low cohesion to elevated symptoms in these populations. Indirect effects via health behaviours were much weaker by comparison.
Prospective associations between low social cohesion and increased depressive symptoms were largely congruent among older adults from England and three Central and Eastern European countries. These associations operated via a psychological, but not a health behavioural, pathway among ageing adults living in diverse parts of Europe.
关于社会凝聚力与抑郁障碍之间的关系，文献中有两个空白。首先，缺乏比较具有不同社区联系和人群中抑郁水平差异的国家的研究。其次，关于解释机制的大多数工作都压倒性地集中在社交网络和社会支持途径上。
我们比较了英格兰、捷克共和国、波兰和俄罗斯老年人中感知邻里社会凝聚力与抑郁症状之间的前瞻性关联；并检验了心理和健康行为途径是否介导了这种关联。
对英国老龄化纵向研究（ELSA）和东欧健康、酒精和心理社会因素研究（HAPIEE）中 26081 名成年人的协调数据进行了分析。使用多变量负二项回归评估基线时感知邻里社会凝聚力与随访时抑郁症状之间的前瞻性关联。使用路径分析检验心理（通过控制生活和控制家庭）和健康行为（通过吸烟和饮酒）途径。
在英国（b=0.106，p=0.001）、捷克（b=0.203，p<0.001）、波兰（0.115，p<0.001）和俄罗斯成年人（b=0.087，p<0.001）中，低凝聚力预示着随访时抑郁症状的数量增加。通过心理机制的间接效应较强，解释了这些人群中低凝聚力到症状升高的总间接效应的 64%（波兰）、82%（俄罗斯）、84%（英格兰）和 95%（捷克共和国）。相比之下，通过健康行为的间接效应要弱得多。
在英格兰和三个中东欧国家的老年人中，低社会凝聚力与抑郁症状增加之间存在前瞻性关联，这些关联在不同地区的欧洲老年人群中通过心理途径而非健康行为途径起作用。
