Simultaneous social causation and social drift: Longitudinal analysis of depression and poverty in South Africa
Simultaneous social causation and social drift: Longitudinal analysis of depression and poverty in South Africa
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DOI：
10.1016/j.jad.2017.12.050
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发表时间：
2018-03-15
影响因子：
6.6
通讯作者：
Cois, Annibale
中科院分区：
文献类型：
--
作者：
Lund, Crick;Cois, Annibale
背景：人们提出了两种理论来解释观察到的抑郁与贫困之间的联系，即社会因果关系和社会漂移。人们对低收入和中等收入国家的社会因果关系和社会漂移的相对重要性知之甚少，这些国家的贫困更为严重，也是世界上大多数抑郁症患者生活的地方。方法：我们分析了来自南非国民收入动态研究的具有全国代表性的纵向数据，同时使用结构方程模型跨三波测试了社会因果关系和社会漂移假设。结果：个体在时间1和时间2时经济状况较差与2年后时间2时抑郁程度较差独立相关（标准化线性回归系数β = -0.110，标准误差（SE）： 0.024）和4年后时间3时（β = -0.113, SE: 0.025）。相反，时间1和时间2较严重的抑郁分别与时间2和时间3较差的经济状况独立相关（beta = -0.037, SE: 0.016）和（beta = -0.028, SE: 0.012）。此外，在基线资产较少的人群中，抑郁对未来资产的“影响”更强。限制：数据轮之间的时间跨度相对较短（四年）；不同种族、年龄和性别群体的回复率不平等；抑郁症的测量是基于自我报告。结论：社会因果关系和社会漂移在这一人群中同时起作用，强化了贫困/抑郁循环。需要制定多部门政策，通过解决抑郁症的经济决定因素来预防抑郁症，并提供循证治疗以减轻抑郁症的经济影响。
Background: Two theories have been proposed to explain the observed association between depression and poverty, namely social causation and social drift. Little is known regarding the relative importance of social causation and social drift in low and middle-income countries, where poverty is more severe and where most of the world's depressed individuals live.Methods: We analysed nationally representative longitudinal data from the National Income Dynamics Study in South Africa and simultaneously tested social causation and social drift hypotheses using structural equation modelling across three waves.Results: Worse individual economic status at time 1 and 2 was independently associated with worse depression two years later at time 2 (standardised linear regression coefficient beta = -0.110, Standard Error (SE): 0.024) and four years later at time 3 (beta = -0.113, SE: 0.025) respectively. Conversely worse depression at time 1 and time 2 was independently associated with worse economic status at time 2 (beta = -0.037, SE: 0.016) and time 3 (beta = -0.028, SE: 0.012) respectively. In addition, the "effect" of depression on future assets was stronger among people with less baseline assets.Limitations: The time span between data rounds is relatively short (four years); response rates are unequal across ethnic, age and sex groups; and the measure of depression is based on self-report.Conclusions: Social causation and social drift act simultaneously in this population, reinforcing poverty/depression cycles. Multi-sectoral policies are required that both prevent depression by addressing its economic determinants, and provide evidence-based treatment to mitigate the economic impact of depression.