Enticott Joanne, Dawadi Shrinkhala, Shawyer Frances, Inder Brett, Fossey Ellie, Teede Helena, Rosenberg Sebastian, Ozols Am Ingrid, Meadows Graham
Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.
Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia.
Front Psychiatry. 2022 Apr 1;13:815904. doi: 10.3389/fpsyt.2022.815904. eCollection 2022.
To examine Australian psychological distress trends from 2001 to 2017/18, including analysis by age, sex, location, and household income.
Secondary analysis of the working age population (18-64 years) in six successive representative national health surveys. Measures were prevalence of psychological distress at very-high symptom level (defined by a Kessler Psychological Distress Scale (K10) score of 30 or more) and combined high/very-high level (K10 score of 22 or more). Very-high K10 scores are associated with mental health problems meeting diagnostic thresholds in past year.
From 2001 to 2017/18 Australian rates of K10 very-high distress rose significantly from 3.8 to 5.1% and combined high/very-high from 13.2 to 14.8%. In women aged 55-64, very-high distress rose significantly and substantially from 3.5 to 7.2% and high/very-high distress from 12.4 to 18.7%. In men aged 25-34, very-high distress increased from 2.1 to 4.0% and high/very-high from 10.6 to 11.5%. Income was strongly and inversely associated with distress (lowest vs. highest quintile adjusted OR 11.4). An apparent association of increased distress with regional location disappeared with adjustment for income.
Australia's population level of psychological distress increased significantly from 2001-2017/18, with levels highest in women and with rates inversely associated with income. This is likely to be indicative of increased community rates of mental disorders. Given that this has occurred whilst mental healthcare expenditure has increased, there is an urgent need to reconsider how best to respond to mental illness, including targeting the most vulnerable based on social determinants such as age, gender, and lower incomes.
研究2001年至2017/18年澳大利亚心理困扰趋势,包括按年龄、性别、地点和家庭收入进行分析。
对连续六次具有代表性的全国健康调查中的工作年龄人口(18 - 64岁)进行二次分析。测量指标为症状水平极高时的心理困扰患病率(由凯斯勒心理困扰量表(K10)得分30分及以上定义)以及高/极高水平合并患病率(K10得分22分及以上)。K10得分极高与过去一年达到诊断阈值的心理健康问题相关。
从2001年到2017/18年,澳大利亚K10极高困扰率从3.8%显著上升至5.1%,高/极高水平合并患病率从13.2%升至14.8%。在55 - 64岁女性中,极高困扰率从3.5%显著大幅升至7.2%,高/极高困扰率从12.4%升至18.7%。在25 - 34岁男性中,极高困扰率从2.1%升至4.0%,高/极高困扰率从10.6%升至11.5%。收入与困扰呈强烈负相关(最低五分位数与最高五分位数调整后的比值比为11.4)。在对收入进行调整后,困扰增加与地区位置之间的明显关联消失。
2001 - 2017/18年澳大利亚心理困扰的人口水平显著上升,女性水平最高,且患病率与收入呈负相关。这可能表明社区精神障碍患病率上升。鉴于此情况在精神卫生保健支出增加的同时发生,迫切需要重新考虑如何最好地应对精神疾病,包括根据年龄、性别和低收入等社会决定因素针对最脆弱人群。