Baker David G, Wang Mengmeng, Filia Kate M, Teo Shu Mei, Morgan Rikki, Ziou Myriam, McGorry Pat, Browne Vivienne, Gao Caroline X
Orygen, Parkville, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
Int J Soc Psychiatry. 2025 Feb;71(1):116-128. doi: 10.1177/00207640241280910. Epub 2024 Sep 26.
Most lifetime mental health disorders begin by age 25 years, and the prevalence among young people has been increasing over recent years. We sought to understand what impact, if any, social determinants have had on this increase through the analysis of an Australian longitudinal dataset (with data from 2007 to 2021).
The analysis focused on five social determinants: loneliness and lack of social support, family relationships, participation in education and employment, receipt of government benefits and relative socio-economic status. We analysed cross-sectional changes in self-reported psychological distress between 2007 and 2021 (using the Kessler-10 item; K10 scores) and examined the effects of these five social determinants on psychological distress using weighted linear regression models.
We identified a significant increase in psychological distress among Australians from 2007 to 2021, with the sharpest rise among those aged 15 to 25 years, who saw more than doubling in the percentage of high and very high K10. This period also saw an increase in the prevalence of social determinants such as loneliness and lack of social support, as well as poor family relationships, particularly in 2021 post COVID-19 pandemic. Regression models suggest loneliness and lack of social support had the most pronounced and increasing impact on psychological distress, followed by poor family relationships.
The observed significant and steady increases in psychological distress and related social determinant factors, particularly loneliness and lack of social support among young people, highlight the urgent need for comprehensive actions. Coordinated research and community-based initiatives are needed to deliver intrapersonal, interpersonal and socially-focused interventions with a holistic approach to support psychosocial wellbeing. Policymakers must adopt a comprehensive shift in political commitment and a whole-of-government approach to address these challenges.
大多数终生心理健康障碍在25岁之前开始，近年来年轻人中的患病率一直在上升。我们试图通过分析一个澳大利亚纵向数据集（包含2007年至2021年的数据）来了解社会决定因素对这种上升是否产生了影响，如果有，影响是什么。
分析聚焦于五个社会决定因素：孤独感和缺乏社会支持、家庭关系、参与教育和就业、领取政府福利以及相对社会经济地位。我们分析了2007年至2021年期间自我报告的心理困扰的横断面变化（使用凯斯勒10项量表；K10得分），并使用加权线性回归模型研究了这五个社会决定因素对心理困扰的影响。
我们发现2007年至2021年期间澳大利亚人的心理困扰显著增加，15至25岁人群中增幅最大，该年龄段K10高分和极高分的百分比增加了一倍多。这一时期，孤独感和缺乏社会支持等社会决定因素的患病率也有所上升，家庭关系不佳的情况也增多，尤其是在2021年新冠疫情之后。回归模型表明，孤独感和缺乏社会支持对心理困扰的影响最为显著且不断增加，其次是家庭关系不佳。
观察到的心理困扰及相关社会决定因素显著且持续增加，尤其是年轻人中的孤独感和缺乏社会支持，凸显了采取全面行动的迫切需求。需要开展协调一致的研究和基于社区的举措，以整体方法提供针对个人、人际和社会层面的干预措施，支持心理社会福祉。政策制定者必须在政治承诺上进行全面转变，并采取政府整体应对的方法来应对这些挑战。
