Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Department of Mental Health and Addiction Services, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Nat Hum Behav. 2024 Sep;8(9):1771-1783. doi: 10.1038/s41562-024-01919-3. Epub 2024 Jul 10.
It is unclear whether poverty and mental illness are causally related. Using UK Biobank and Psychiatric Genomic Consortium data, we examined evidence of causal links between poverty and nine mental illnesses (attention deficit and hyperactivity disorder (ADHD), anorexia nervosa, anxiety disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder and schizophrenia). We applied genomic structural equation modelling to derive a poverty common factor from household income, occupational income and social deprivation. Then, using Mendelian randomization, we found evidence that schizophrenia and ADHD causally contribute to poverty, while poverty contributes to major depressive disorder and schizophrenia but decreases the risk of anorexia nervosa. Poverty may also contribute to ADHD, albeit with uncertainty due to unbalanced pleiotropy. The effects of poverty were reduced by approximately 30% when we adjusted for cognitive ability. Further investigations of the bidirectional relationships between poverty and mental illness are warranted, as they may inform efforts to improve mental health for all.
贫困与精神疾病是否存在因果关系尚不清楚。本研究利用英国生物库和精神疾病基因组学联合会的数据,考察了贫困与九种精神疾病(注意缺陷多动障碍(ADHD)、神经性厌食症、焦虑症、自闭症谱系障碍、双相情感障碍、重度抑郁症、强迫症、创伤后应激障碍和精神分裂症)之间是否存在因果关系的证据。我们应用基因组结构方程模型从家庭收入、职业收入和社会剥夺中提取贫困共同因素。然后,通过孟德尔随机化,我们发现精神分裂症和 ADHD 可导致贫困,而贫困可导致重度抑郁症和精神分裂症,但可降低神经性厌食症的风险。贫困也可能与 ADHD 有关,但由于存在不平衡的多效性,其因果关系存在不确定性。当我们调整认知能力时,贫困的影响降低了约 30%。需要进一步研究贫困与精神疾病之间的双向关系,因为这可能有助于改善所有人的精神健康。