Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, Arrasate-Mondragón, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Spain; REDISSEC (Health Services Research on Chronic Patients Network), Bilbao, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain.
Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, Arrasate-Mondragón, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain.
Span J Psychiatry Ment Health. 2024 Apr-Jun;17(2):95-102. doi: 10.1016/j.rpsm.2022.07.001. Epub 2022 Jul 16.
Socioeconomic status (SES) and gender play a key role in mental health. The objective of this study was to assess socioeconomic and gender mental health inequalities in adolescents and young adults using a population-based registry.
We conducted a lifetime follow-up study of all residents in the Basque Country between 1 and 30 years old (n=609,381) as of 31 December 2018. Primary care, specialized outpatient, and hospital care records were searched for diagnoses. SES was assessed based on household income. We estimated disaggregated lifetime prevalence of substance use, behaviour, anxiety, depression, psychosis, and attention deficit hyperactivity disorder. The local Institute of Statistics validated the mortality data. The likelihood of risks was estimated using logistic regression.
Overall, 96,671 individuals (15.9%) had a diagnosed mental disorder, with clear gradients by gender and SES. Females of medium-to-high SES had the lowest prevalence of all mental disorders, except anxiety and depression. This group was followed by males of the same SES and females of low SES, while the highest prevalence of mental disorders was observed in low-SES males. The lower income categories had higher risks of psychiatric admission (adjusted odds ratio [AOR]: 3.64 for females; 6.66 for males) and death (AOR: 5.42). People with a mental health diagnosis had higher mortality (AOR: 2.38).
Our work evidenced important SES and gender inequalities in the mental health and premature mortality of adolescents and young adults, findings that should drive the development and implementation of early preventive interventions.
社会经济地位（SES）和性别在心理健康中起着关键作用。本研究的目的是使用基于人群的登记处评估青少年和年轻人的社会经济和性别心理健康不平等。
我们对截至 2018 年 12 月 31 日，巴斯克地区年龄在 1 至 30 岁之间的所有居民（n=609381）进行了终身随访研究。初级保健、专科门诊和医院护理记录中搜索了诊断记录。SES 根据家庭收入进行评估。我们估计了物质使用、行为、焦虑、抑郁、精神病和注意缺陷多动障碍的终生患病率。当地统计局验证了死亡率数据。使用逻辑回归估计风险的可能性。
总体而言，有 96671 人（15.9%）被诊断患有精神障碍，性别和 SES 存在明显的梯度。中高 SES 的女性除了焦虑和抑郁之外，所有精神障碍的患病率最低。其次是同 SES 的男性和低 SES 的女性，而低 SES 男性的精神障碍患病率最高。较低的收入类别有更高的精神科入院风险（调整后的优势比 [AOR]：女性为 3.64；男性为 6.66）和死亡风险（AOR：女性为 5.42）。有精神健康诊断的人死亡率更高（AOR：2.38）。
我们的工作表明，青少年和年轻人的心理健康和过早死亡存在重要的 SES 和性别不平等，这些发现应该推动早期预防干预的制定和实施。
