Early-life mental disorders and adult household income in the World Mental Health Surveys.

Early-life mental disorders and adult household income in the World Mental Health Surveys.
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DOI:
10.1016/j.biopsych.2012.03.009
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发表时间:
2012-08-01
影响因子:
10.6
通讯作者:
Kessler, Ronald C.
Kessler, Ronald C.
中科院分区:
医学1区
文献类型:
--
作者:
Kawakami, Norito;Abdulghani, Emad Abdulrazaq;Alonso, Jordi;Bromet, Evelyn J.;Bruffaerts, Ronny;Caldas-de-Almeida, Jose Miguel;Chiu, Wai Tat;de Girolamo, Giovanni;de Graaf, Ron;Fayyad, John;Ferry, Finola;Florescu, Silvia;Gureje, Oye;Hu, Chiyi;Lakoma, Matthew D.;LeBlanc, William;Lee, Sing;Levinson, Daphna;Malhotra, Savita;Matschinger, Herbert;Elena Medina-Mora, Maria;Nakamura, Yosikazu;Browne, Mark A. Oakley;Okoliyski, Michail;Posada-Villa, Jose;Sampson, Nancy A.;Viana, Maria Carmen;Kessler, Ronald C.

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更好地了解早发性精神障碍的人力资本成本可以提高政策制定者对扩大早期发现和治疗倡议的价值的敏感度。关于这些成本的一个重要方面的数据是:早发性精神障碍与成人家庭收入的关联。数据来自世卫组织对11个高收入国家、5个中上收入国家和6个低/中低收入国家的世界精神卫生调查。通过世界卫生组织综合国际诊断访谈对截至完成教育年龄的15种终生精神障碍的信息进行回顾评估,以预测控制教育水平的18-(n=37,741)受访者目前的家庭收入。总关联度被分解,以评估通过家庭收入的主要组成部分的中介作用。早发性精神障碍与高收入和中上等收入国家的家庭收入大幅减少有关,但与低/中低收入国家无关,女性的相关性始终强于男性。总的关联主要是由于个人收入低(失业增加,就业人员收入减少)和配偶收入(结婚的概率降低,如果结婚,配偶就业和就业配偶收入低)。个人层面的效应规模相当于国内家庭收入中位数的16%-33%,而人口层面的效应规模则在家庭总收入的1.0%-1.4%之间。早期精神障碍与个人和社会层面的教育净收入大幅减少有关。政策制定者在做出医疗研究和治疗资源分配决策时应考虑到这些关联。
Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy-makers to the value of expanding initiatives for early detection-treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Data come from the WHO World Mental Health (WMH) Surveys in eleven high income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents ages 18-64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16-33% of median within-country household income, while population-level effect sizes are in the range 1.0-1.4% of Gross Household Income. Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy-makers should take these associations into consideration in making healthcare research and treatment resource allocation decisions.
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发表时间: 2009-05-01
影响因子: 10.5
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发表时间: 2008-06-01
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DOI: 10.1001/jama.291.21.2581
发表时间: 2004-06-02
影响因子: 120.7
作者:
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通讯作者: Chatterji, S
DOI: 10.1192/bjp.bp.107.036079
发表时间: 2007-10-01
影响因子: 10.5
作者:
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