Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands.
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Adm Policy Ment Health. 2021 Sep;48(5):810-820. doi: 10.1007/s10488-021-01131-9. Epub 2021 Apr 13.
Researchers and politicians have regularly expressed their worries about a widening of socioeconomic inequalities in physical and mental health. Debts have been relatively understudied as a specific aspect of socioeconomic disadvantage contributing to poor mental health. This study examines the bidirectional association between debts and common mental disorders (CMDs) in the adult population of the Netherlands. Data were obtained from the second ('baseline') and third (3-year follow-up) wave of the Netherlands Mental Health Survey and Incidence Study-2, a representative cohort of adults. Questions were asked about debts and difficulty in repaying debts in the past 12 months. The answers were combined into one variable: no debts, easy, difficult, and very difficult to pay back debts. Twelve-month CMDs were assessed with the Composite International Diagnostic Interview version 3.0. Increasing levels of difficulty in repaying debts predicted onset of CMD at follow-up in those without 12-month CMD at baseline, and persistence of CMD at follow-up in those with 12-month CMD at baseline. Conversely, CMD was not linked to onset of debts at follow-up in those without 12-month debts at baseline, but was associated with persistence of difficulty to pay back debts at follow-up in those with 12-month debts at baseline. These associations remained significant after adjustment for baseline sociodemographic variables, negative life events and physical health. Health professionals and debt counsellors should pay more attention to patients' debts and clients' mental health respectively in order to refer those with financial or mental health problems to the appropriate services.
研究人员和政治家经常对身心健康方面的社会经济不平等扩大表示担忧。债务作为导致心理健康状况不佳的社会经济劣势的一个特定方面，相对来说研究得还不够。本研究考察了荷兰成年人中债务与常见精神障碍（CMD）之间的双向关联。数据来自荷兰心理健康调查和发病率研究-2 的第二（基线）和第三（3 年随访）波，这是一个具有代表性的成年人队列。在过去 12 个月中，询问了有关债务和偿还债务困难的问题。答案被合并为一个变量：无债务、容易、困难和非常难以偿还债务。使用复合国际诊断访谈 3.0 版评估了 12 个月 CMD。在基线时没有 12 个月 CMD 的人群中，偿还债务的难度增加预示着随访时出现 CMD，在基线时有 12 个月 CMD 的人群中，随访时出现 CMD 的情况持续存在。相反，在基线时没有 12 个月债务的人群中，CMD 与随访时出现债务无关，但与基线时有 12 个月债务的人群中随访时偿还债务困难持续存在有关。在调整基线社会人口统计学变量、负性生活事件和身体健康状况后，这些关联仍然显著。卫生专业人员和债务顾问应更加关注患者的债务和客户的心理健康，以便将有财务或心理健康问题的患者转介给适当的服务机构。
