Cultural values and the prevalence of mental disorders in 25 countries: A secondary data analysis
Cultural values and the prevalence of mental disorders in 25 countries: A secondary data analysis
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DOI：
10.1016/j.socscimed.2017.07.024
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发表时间：
2017-09-01
影响因子：
5.4
通讯作者：
Maercker, Andreas
中科院分区：
文献类型：
--
作者：
Heim, Eva;Wegmann, Iris;Maercker, Andreas
理由：常见精神障碍（CMD，即，抑郁症和焦虑症）的发病率在世界范围内很高，高收入国家的发病率高于低收入和中等收入国家。这种差异可能反映了基本的流行率以及跨国流行病学研究中使用的计量模型。Schwartz的文化价值观提供了一个有意义的分类来描述“文化”，并研究文化如何影响CMDs.Objective的病因学和现象学：本研究探讨在何种程度上Schwartz的文化价值观与CMDs.Methods的患病率在国家一级的相关性：25个国家被纳入本研究。如果能够从世界精神卫生调查或全球疾病负担研究中获得至少一种CMD的文化价值观和终生患病率数据，则将这些国家包括在内。斯皮尔曼等级之间的相关性计算患病率和文化价值观，控制国民总收入（GNI）人均。对于焦虑症，相关性较低，但仍然提供了有意义的见解。相关性遵循价值观的循环结构，这意味着关系的强度在绕圈移动时会下降并再次增加：与平等主义的正相关性最强，与等级制度和掌握的负相关性最强。嵌入性维度弱相关的患病率CMDs.Conclusions：高收入国家和低收入和中等收入国家之间的不同患病率与文化价值观的差异。价值观可能不仅与精神障碍的病因有关，而且最有可能影响心理痛苦的表达方式。例如，在高度重视嵌入性的社会中，对污名化的恐惧可能更为明显。文化价值观提供了一个文化特定（即，主位的）和普遍主义的（即，etic）研究。(C)2017爱思唯尔有限公司版权所有。
Rationale: The prevalence of common mental disorders (CMDs, i.e., depression and anxiety) worldwide is substantial, and prevalence rates are higher in high-income than in low-and middle-income countries. This difference might reflect both underlying prevalence rates as well as the measurement model used in cross-national epidemiological studies. Schwartz' cultural values provide a meaningful taxonomy to describe 'culture' and to examine how culture affects both the aetiology and phenomenology of CMDs.Objective: The present study examines to what extent Schwartz' cultural values correlate with prevalence rates of CMDs at the country-level.Method: Twenty-five countries were included in this study. Countries were included if data on cultural values and lifetime prevalence rates, from either the World Mental Health Surveys or the Global Burden of Disease Study, were available for at least one CMD. Spearman rank correlations were calculated between prevalence rates and cultural values, controlling for gross national income (GNI) per capita.Results: Affective disorders correlated with cultural values, after controlling for GNI. For anxiety disorders, correlations were lower but still offered meaningful insights. Correlations followed the circular structure of values, meaning that the strength of relationship decreased and increased again when moving around the circle: the strongest positive correlations were found with egalitarianism, and the strongest negative correlations with hierarchy and mastery. The autonomy-embeddedness dimension correlated weakly with the prevalence of CMDs.Conclusions: Diverging prevalence rates between high-income countries and low- and middle-income countries are associated with differences in cultural values. Values might not only relate to the aetiology of mental disorders, but most possibly affect the way in which psychological distress is expressed. As an example, in societies with a strong focus on embeddedness, the fear of stigma might be more pronounced. Cultural values offer a middle ground between culturally specific (i.e., emic) and universalist (i.e., etic) research. (C) 2017 Elsevier Ltd. All rights reserved.