Education as a predictor of antidepressant and anxiolytic medication use after bereavement: a population-based record linkage study.
Education as a predictor of antidepressant and anxiolytic medication use after bereavement: a population-based record linkage study.
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DOI：
10.1007/s11136-016-1440-1
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发表时间：
2017-05
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影响因子：
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通讯作者：
McCann M
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作者：
Maguire A;Moriarty J;O'Reilly D;McCann M
教育程度已被证明与心理健康呈正相关，并可能缓冲应激事件。在每个人的一生中，一个可能会影响到他们的压力的生活事件就是失去亲人。本文评估了受教育程度对丧亲后心理健康的影响。通过利用大型行政数据集，将人口普查申报单与死亡记录和处方药物数据联系起来，我们分析了年龄在25-74岁之间的208,332人的丧亲风险敞口。建立了两水平多水平Logistic回归模型，以确定在给定教育程度的情况下，丧亲后使用抗抑郁药物(精神疾病的代用品)的可能性。失去亲人的人比没有失去亲人的人使用更多的抗抑郁药，超过四分之一(26.5%)的自杀失去亲人的人在接受抗抑郁药物治疗，而在没有失去亲人的人中，这一比例仅为12.4%。在因猝死而失去亲人的人中，在充分调整人口、社会经济和地区因素后，拥有大学学位或更高学历的人接受抗抑郁药物治疗的可能性比没有学历的人低73%(OR 0.27，95%CI 0.09，0.75)。对于那些因自杀而失去亲人的人来说，更高的教育程度和没有资格证书具有同等的效果。教育可以防止精神健康不良，通过使用抗抑郁药物来衡量，在丧亲后，除了那些因自杀而失去亲人的人。这很可能是因为花在教育上的时间提高了认知、个人和心理技能。本文的在线版本(doi：10.1007/s11136-0161440-1)包含补充材料，授权用户可以使用。
Educational attainment has been shown to be positively associated with mental health and a potential buffer to stressful events. One stressful life event likely to affect everyone in their lifetime is bereavement. This paper assesses the effect of educational attainment on mental health post-bereavement. By utilising large administrative datasets, linking Census returns to death records and prescribed medication data, we analysed the bereavement exposure of 208,332 individuals aged 25–74 years. Two-level multi-level logistic regression models were constructed to determine the likelihood of antidepressant medication use (a proxy of mental ill health) post-bereavement given level of educational attainment. Individuals who are bereaved have greater antidepressant use than those who are not bereaved, with over a quarter (26.5 %) of those bereaved by suicide in receipt of antidepressant medication compared to just 12.4 % of those not bereaved. Within individuals bereaved by a sudden death, those with a university degree or higher qualifications are 73 % less likely to be in receipt of antidepressant medication compared to those with no qualifications, after full adjustment for demographic, socio-economic and area factors (OR 0.27, 95 % CI 0.09,0.75). Higher educational attainment and no qualifications have an equivalent effect for those bereaved by suicide. Education may protect against poor mental health, as measured by the use of antidepressant medication, post-bereavement, except in those bereaved by suicide. This is likely due to the improved cognitive, personal and psychological skills gained from time spent in education. The online version of this article (doi:10.1007/s11136-016-1440-1) contains supplementary material, which is available to authorized users.