Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Way, Nashville, TN, USA.
Danang Psychiatric Hospital, 193 Nguyen Luong Bang Street, Danang, Vietnam.
Soc Psychiatry Psychiatr Epidemiol. 2020 Mar;55(3):359-369. doi: 10.1007/s00127-019-01761-3. Epub 2019 Aug 28.
The United Nations Sustainable Development Goals include gender equality for women, including health, as one of seventeen targets. Within this broad domain, a wide range of research indicates that being female is associated with increased risk for mental health problems, particularly in low- and middle-income countries (LMIC). What is less clear are the trans-diagnostic demographic and environmental risk factors in LMIC that may underlie this increased risk. The purpose of the present study was to identify socio-economic and related disadvantages potentially underlying increased risk for women for mental health-related problems in the Southeast Asian LMIC of Vietnam.
Nine hundred and seventy-seven adults were randomly selected from five provinces in central coastal Vietnam. Individuals were assessed cross-sectionally for depression (PHQ-9), anxiety (GAD-7), post-traumatic stress disorder symptoms (PDS), somatic syndrome (SCL-90-R), alcohol dependence (ICD-10), functional impairment (PDS life functioning section), and self-perceived general physical health (SF-36). Trans-diagnostic risk factors assessed included financial stress, education level, exposure to traumatic events, and others.
At the multivariate level, gender explained approximately 5% of the variance in mental health symptoms, with women significantly higher in all mental health domains except alcohol dependency. The trans-diagnostic risk factors explained slightly over half of this variance, with financial stress and lower education levels the two strongest individual explanatory variables for women's increased risk for mental health problems.
These results suggest that support for gender equality including in regard to economic stability and education may be critical for reducing broad gender disparities in mental health functioning.
联合国可持续发展目标包括妇女健康在内的性别平等，作为十七项具体目标之一。在这一广泛领域内，大量研究表明，女性面临更高的心理健康问题风险，尤其是在中低收入国家（LMIC）。但在这些国家中，哪些跨诊断的人口统计学和环境风险因素可能导致这种风险增加，目前还不太清楚。本研究的目的是确定越南等东南亚 LMIC 中潜在导致女性心理健康相关问题风险增加的社会经济和相关劣势。
从越南北部沿海五个省随机选择了 977 名成年人。采用 PHQ-9、GAD-7、PDS、SCL-90-R、ICD-10、PDS 生活功能部分和 SF-36 等评估工具，对抑郁、焦虑、创伤后应激障碍症状、躯体综合征、酒精依赖、功能障碍和自我感知的一般身体健康进行横断面评估。评估的跨诊断风险因素包括经济压力、教育水平、创伤事件暴露等。
在多变量水平上，性别解释了心理健康症状约 5%的差异，女性在除酒精依赖以外的所有心理健康领域的得分均显著更高。跨诊断风险因素解释了略超过一半的方差，其中经济压力和较低的教育水平是女性心理健康问题风险增加的两个最强的个体解释变量。
这些结果表明，支持性别平等，包括经济稳定和教育，对于减少心理健康功能方面的广泛性别差距可能至关重要。
