Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study.
Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study.
复制标题
DOI：
10.1186/s12889-016-3332-2
复制
发表时间：
2016-08-11
影响因子：
4.5
通讯作者：
Smidt N
中科院分区：
文献类型：
--
作者：
Klijs B;Kibele EU;Ellwardt L;Zuidersma M;Stolk RP;Wittek RP;Mendes de Leon CM;Smidt N
之前的研究没有确定附近糟糕的社会经济状况是否与严重的抑郁障碍有关。此外，将邻居状况与抑郁障碍联系起来的概念模型还没有使用经验数据进行评估。在这项研究中，我们调查了社区收入是否与重大抑郁发作有关。我们评估了三个概念模型。概念模型1：通过疾病、生活方式因素、压力和社会参与来解释邻里收入和主要抑郁发作之间的关联。概念模型2：相对于社区平均收入而言，个人收入较低与严重的抑郁发作有关。概念模型3：社区的高收入缓冲了个人收入低对严重抑郁障碍的影响。我们使用了生命线队列研究(N = 71,058)中的成人基线数据，并将参与者所在社区的数据与荷兰统计局的数据联系起来。使用迷你神经精神病学访谈来评估目前是否存在严重的抑郁发作。通过对年龄、性别、婚姻状况、教育程度和个人(平均)收入进行调整的混合效应Logistic回归模型，评估了社区收入和主要抑郁发作之间的关联。该回归模型按生活方式因素、慢性病、压力和社会参与的顺序进行调整，以评估概念模型1。为了评估概念模型2和3，包括了邻里收入*个人收入的交互作用项。多因素回归分析显示，社区收入低与主要抑郁发作有关(OR(95%CI)：0.82(0.73；0.93))。对疾病、生活方式因素、压力和社会参与的调整减弱了这种联系(OR(95%CI)：0.90(0.79；1.01))。个人收入低也与主要抑郁发作有关(OR(95%CI)：0.72(0.68；0.76))。个人收入*邻里收入对主要抑郁发作的交互作用不显著(p = 0.173)。生活在低收入社区会导致严重的抑郁发作。我们的结果表明，慢性病、生活方式因素、压力和较差的社会参与部分解释了这种联系，从而部分证实了概念模型1。我们的结果不支持概念模型2和3。
Previous studies are inconclusive on whether poor socioeconomic conditions in the neighborhood are associated with major depressive disorder. Furthermore, conceptual models that relate neighborhood conditions to depressive disorder have not been evaluated using empirical data. In this study, we investigated whether neighborhood income is associated with major depressive episodes. We evaluated three conceptual models. Conceptual model 1: The association between neighborhood income and major depressive episodes is explained by diseases, lifestyle factors, stress and social participation. Conceptual model 2: A low individual income relative to the mean income in the neighborhood is associated with major depressive episodes. Conceptual model 3: A high income of the neighborhood buffers the effect of a low individual income on major depressive disorder. We used adult baseline data from the LifeLines Cohort Study (N = 71,058) linked with data on the participants’ neighborhoods from Statistics Netherlands. The current presence of a major depressive episode was assessed using the MINI neuropsychiatric interview. The association between neighborhood income and major depressive episodes was assessed using a mixed effect logistic regression model adjusted for age, sex, marital status, education and individual (equalized) income. This regression model was sequentially adjusted for lifestyle factors, chronic diseases, stress, and social participation to evaluate conceptual model 1. To evaluate conceptual models 2 and 3, an interaction term for neighborhood income*individual income was included. Multivariate regression analysis showed that a low neighborhood income is associated with major depressive episodes (OR (95 % CI): 0.82 (0.73;0.93)). Adjustment for diseases, lifestyle factors, stress, and social participation attenuated this association (ORs (95 % CI): 0.90 (0.79;1.01)). Low individual income was also associated with major depressive episodes (OR (95 % CI): 0.72 (0.68;0.76)). The interaction of individual income*neighborhood income on major depressive episodes was not significant (p = 0.173). Living in a low-income neighborhood is associated with major depressive episodes. Our results suggest that this association is partly explained by chronic diseases, lifestyle factors, stress and poor social participation, and thereby partly confirm conceptual model 1. Our results do not support conceptual model 2 and 3.