Debt, income and mental disorder in the general population
Debt, income and mental disorder in the general population
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DOI：
10.1017/s0033291707002516
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发表时间：
2008-10-01
影响因子：
6.9
通讯作者：
Meltzer, H.
中科院分区：
文献类型：
--
作者：
Jenkins, R.;Bhugra, D.;Meltzer, H.
背景。心理健康状况不佳与贫困之间的联系众所周知，但其机制尚不完全清楚。本研究检验了以下假设：低收入与精神障碍之间的关联是由债务及其随之而来的财务困难介导的。方法。该研究是一项针对英格兰、苏格兰和威尔士私人家庭的全国性横断面代表性调查，评估了生活在普通家庭中的 8580 名 16 至 74 岁的参与者。精神病、神经症、酒精滥用和药物滥用是通过临床访谈时间表修订版、神经精神病学评估时间表（SCAN）、酒精使用障碍识别测试（AUDIT）和其他措施来识别的。询问了有关收入、债务和财务困难的详细问题。结果。低收入者更有可能患有精神障碍[比值比 (OR) 2.09，95% 置信区间 (CI) 1.68-2.59]，但这种关系在债务调整后减弱（OR 1.58，95% CI 1.25-1.97），并且当其他社会人口统计学变量也受到控制时消失（OR 1.07，95% CI） 0.77-1.48）。在患有精神障碍的人中，23% 的人负债累累（相比之下，无精神障碍的人只有 8%），10% 的人曾被切断过公用设施（相比之下，这一比例为 3%）。人们背负的债务越多，就越有可能患上某种形式的精神障碍，即使在调整了收入和其他社会人口变量之后也是如此。拥有六项或以上单独债务的人在调整收入后，精神障碍增加了六倍（OR 6.0，95% CI 3.5-10.3）。结论。低收入和债务都与精神疾病有关，但收入的影响似乎主要是由债务调节的。
Background. The association between poor mental health and poverty is well known but its mechanism is not fully understood. This study tests the hypothesis that the association between low income and mental disorder is mediated by debt and its attendant financial hardship.Method. The study is a cross-sectional nationally representative survey of private households in England, Scotland and Wales, which assessed 8580 participants aged 16-74 years living in general households. Psychosis, neurosis, alcohol abuse and drug abuse were identified by the Clinical Interview Schedule-Revised, the Schedule for Assessment in Neuropsychiatry (SCAN), the Alcohol Use Disorder Identification Test (AUDIT) and other measures. Detailed questions were asked about income, debt and financial hardship.Results. Those with low income were more likely to have mental disorder [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.68-2.59] but this relationship was attenuated after adjustment for debt (OR 1.58, 95% CI 1.25-1.97) and vanished when other sociodemographic variables were also controlled (OR 1.07, 95% CI 0.77-1.48). Of those with mental disorder, 23% were in debt (compared with 8% of those without disorder), and 10% had had a utility disconnected (compared with 3%). The more debts people had, the more likely they were to have some form of mental disorder, even after adjustment for income and other sociodemographic variables. People with six or more separate debts had a six-fold increase in mental disorder after adjustment for income (OR 6.0, 95 % CI 3.5-10.3).Conclusions. Both low income and debt are associated with mental illness, but the effect of income appears to be mediated largely by debt.