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焦虑、抑郁和自杀加速:与2019冠状病毒病相关的经济混乱的次生影响

Acceleration of Anxiety, Depression, and Suicide: Secondary Effects of Economic Disruption Related to COVID-19.

作者信息

Brenner M Harvey, Bhugra Dinesh

机构信息

School of Public Health, Health Policy and Management, Johns Hopkins University Bloomberg, Baltimore, MD, United States.

University of North Texas Health Science Center, Fort Worth, TX, United States.

出版信息

Front Psychiatry. 2020 Dec 15;11:592467. doi: 10.3389/fpsyt.2020.592467. eCollection 2020.

Abstract

The SARS-CoV-2 (COVID-19) pandemic has contributed to increasing levels of anxiety, depression and other symptoms of stress around the globe. Reasons for this increase are understandable in the context of individual level factors such as self-isolation, lockdown, grief, survivor guilt, and other factors but also broader social and economic factors such as unemployment, insecure employment and resulting poverty, especially as the impacts of 2008 recession are still being felt in many countries further accompanied by social isolation. For those who are actively employed a fear of job and income loss and those who have actually become ill and recovered or those who have lost family and friends to illness, it is not surprising that they are stressed and feeling the psychological impact. Furthermore, multiple uncertainties contribute to this sense of anxiety. These fears and losses are major immediate stresses and undoubtedly can have long-term implications on mental health. Economic uncertainty combined with a sense of feeling trapped and resulting lack of control can contribute to helplessness and hopelessness where people may see suicide as a way out. Taking a macro view, we present a statistical model of the impact of unemployment, and national income declines, on suicide, separately for males and females over the life cycle in developed countries. This impact may reflect a potent combination of social changes and economic factors resulting in anomie. The governments and policymakers have a moral and ethical obligation to ensure the physical health and well-being of their populations. While setting in place preventive measures to avoid infections and then subsequent mortality, the focus on economic and social recovery is crucial. A global pandemic requires a global response with a clear inter-linked strategy for health as well as economic solutions. The models we have constructed represent predictions of suicide rates among the 38 highly industrialized OECD countries over a period of 18 years (2000-2017). Unemployment has a major effect on increasing suicide, especially in middle-aged groups. However, the impact of economic decline through losses of national income (GDP per capita) are substantially greater than those of unemployment and influence suicide throughout the life course, especially at the oldest ages.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新冠病毒)大流行致使全球焦虑、抑郁及其他压力症状水平不断上升。在诸如自我隔离、封锁、悲痛、幸存者内疚等个人层面因素,以及更广泛的社会和经济因素(如失业、就业不稳定及由此导致的贫困)的背景下,这种上升的原因是可以理解的,特别是在许多国家仍能感受到2008年经济衰退的影响,且还伴有社会隔离的情况下。对于那些在职人员,担心失去工作和收入;对于那些实际患病后康复的人,以及那些因疾病失去家人和朋友的人来说,他们感到压力并受到心理影响也就不足为奇了。此外,多种不确定性加剧了这种焦虑感。这些恐惧和损失是主要的直接压力源,无疑会对心理健康产生长期影响。经济不确定性加上被困感以及由此产生的缺乏掌控感,可能导致无助和绝望,人们可能将自杀视为一种解脱方式。从宏观角度看,我们提出了一个统计模型,分别针对发达国家生命周期内的男性和女性,研究失业和国民收入下降对自杀的影响。这种影响可能反映了社会变革和经济因素导致失范的有力结合。政府和政策制定者有道义责任确保民众的身体健康和福祉。在制定预防措施以避免感染及随后的死亡时,关注经济和社会复苏至关重要。全球大流行需要全球做出回应,要有明确的相互关联的健康战略以及经济解决方案。我们构建的模型代表了对38个高度工业化的经合组织国家在18年(2000 - 2017年)期间自杀率的预测。失业对自杀率上升有重大影响,尤其是在中年群体中。然而,国民收入(人均国内生产总值)下降导致的经济衰退对自杀的影响远大于失业,且在整个生命过程中都有影响,尤其是在老年阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d02/7771384/9aef3edc6f86/fpsyt-11-592467-g0001.jpg

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