Socioeconomic status in childhood and the lifetime risk of major depression
Socioeconomic status in childhood and the lifetime risk of major depression
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DOI：
10.1093/ije/31.2.359
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发表时间：
2002-04-01
影响因子：
7.7
通讯作者：
Buka, SL
中科院分区：
文献类型：
--
作者：
Gilman, SE;Kawachi, I;Buka, SL
背景
重度抑郁症在社会经济地位较低的人群以及女性中更为常见。尽管已经有大量的研究，但社会经济地位和性别在抑郁症方面的差异的形成仍未得到充分解释。在这项研究中，我们检验以下假设：童年时期社会经济地位低预示着成年后患抑郁症的风险增加，并导致女性患抑郁症的风险更高。
方法
研究对象是1959年至1966年间参加美国国家围产期合作项目罗得岛州普罗维登斯地区研究的1132名母亲的成年子女。以父母职业为指标的童年社会经济地位在参与者出生时和7岁时进行评估。根据诊断标准通过结构化访谈确定重度抑郁发作的终生病史和发病年龄。生存分析被用于模拟首次抑郁症发病的可能性与童年社会经济地位的函数关系。
结果
与社会经济地位最高的背景相比，社会经济地位较低背景的参与者患重度抑郁症的风险几乎增加了一倍，且不受童年社会人口统计学因素、精神疾病家族史和成年社会经济地位的影响。对童年社会经济地位对成年抑郁症影响的性别差异分析为童年社会经济地位导致成年抑郁症性别差异这一假设提供了一定的支持。
结论
童年时期社会经济地位低与成年人患重度抑郁症的高风险相关。抑郁症中的社会不平等可能起源于生命早期。需要进一步的研究来确定将童年状况与重度抑郁症发病率的社会经济地位差异联系起来的途径。
Background Major depression occurs more frequently among people of lower socioeconomic status (SES) and among females. Although the focus of considerable investigation, the development of SES and sex differences in depression remains to be fully explained. In this study, we test the hypotheses that low childhood SES predicts an increased risk of adult depression and contributes to a higher risk of depression among females.Methods Participants were 1132 adult offspring of mothers enrolled in the Providence, Rhode Island site of the US National Collaborative Perinatal Project between 1959 and 1966. Childhood SES, indexed by parental occupation, was assessed at the time of participants' birth and seventh year. A lifetime history and age at onset of major depressive episode were ascertained via structured interviews according to diagnostic criteria. Survival analyses were used to model the likelihood of first depression onset as a function of childhood SES.Results Participants from lower SES backgrounds had nearly a twofold increase in risk for major depression compared to those from the highest SES background independent of childhood sociodemographic factors, family history of mental illness, and adult SES. Analyses of sex differences in the effect of childhood SES on adult depression provided modest support for the hypothesis that childhood SES contributes to adult sex differences in depression.Conclusions Low SES in childhood is related to a higher risk of major depression in adults. Social inequalities in depression likely originate early in life. Further research is needed to identify the pathways linking childhood conditions to SES differences in the incidence of major depression.