泰国成年人饮酒障碍与抑郁障碍之间关联的社会经济不平等：一项基于人群的研究。
Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study.
机构信息
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
出版信息
BMC Psychiatry. 2020 Nov 23;20(1):553. doi: 10.1186/s12888-020-02958-6.
BACKGROUND
Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups.
METHODS
We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels.
RESULTS
The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77).
CONCLUSION
Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.
背景
先前的证据表明，抑郁障碍与酒精使用障碍（AUD）之间存在显著关联，且它们与社会状况密切相关。本研究旨在调查不同社会经济群体中重度抑郁发作（MDE）与 AUD 之间的关联。
方法
我们分析了来自泰国 2014 年全国健康检查调查的数据，该调查包含了来自一般人群的 13177 名年龄大于 20 岁的成年人的随机样本。使用酒精使用障碍识别测试将受访者分为非问题饮酒者（得分 0-7）、危险饮酒者（得分 8-15）和有害依赖饮酒者（得分 16-40）。使用基于 DSM-IV 的问题来确定 MDE。使用多项逻辑回归计算调整后的优势比（AOR）和 95%置信区间（CI），以确定 MDE 作为预测因子与 AUD 作为结局变量之间的关联强度，跨越不同的社会经济水平。
结果
MDE、危险和有害依赖饮酒的患病率分别为 2.5%、10.3%和 1.9%。MDE 与 AUD 之间的关联受到财富指数、教育水平和居住地区的调节。在财富指数最高（AOR=8.68，95%CI：5.34，14.11）和最低（AOR=7.14，95%CI：3.71，13.73）水平的个体中，MDE 与有害依赖饮酒之间的关联的 AOR 较高，但在中间水平（AOR=1.78，95%CI：0.74，4.25）中则不显著。教育对 MDE 与有害依赖饮酒之间的关系影响最大（完成中学或以上教育者的 AOR=16.0，95%CI：10.30，24.90，仅完成小学教育者的 AOR=1.44，95%CI：0.63，3.33）。与生活在农村地区的人相比（AOR=4.73，95%CI：3.31，6.77），生活在城市地区的人 MDE 与有害依赖饮酒之间的关联更高（AOR=8.50，95%CI：5.50，13.13）。
结论
社会经济因素改变了泰国人酒精使用障碍与重度抑郁障碍之间的关联。
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