Associations of financial strain and income with depressive and anxiety disorders
Associations of financial strain and income with depressive and anxiety disorders
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DOI：
10.1136/jech-2014-205088
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发表时间：
2015-07-01
影响因子：
6.3
通讯作者：
van Marwijk, Harm W. J.
中科院分区：
文献类型：
--
作者：
Dijkstra-Kersten, Sandra M. A.;Biesheuvel-Leliefeld, Karolien E. M.;van Marwijk, Harm W. J.
背景先前的研究表明，抑郁症的患病率和发病存在社会经济不平等。除了收入等客观指标外，目前尚不清楚感知到的经济压力是否与抑郁症和/或焦虑症有关。本研究探讨了经济压力是否与收入以上人群抑郁和/或焦虑症的患病率和发病/复发有关。方法数据来源于荷兰抑郁与焦虑研究。2937名参与者（18-65岁）在基线时评估了经济压力、收入和抑郁和/或焦虑障碍之间的关系。在1250名基线时无抑郁或焦虑障碍的参与者中，研究了经济压力和收入对抑郁和/或焦虑障碍4年发病/复发的影响。采用综合国际诊断访谈法确定抑郁和焦虑障碍。财务压力和收入是在面试中评估的。结果：在调整收入后，与健康对照组相比，轻度或重度财务紧张的参与者在基线时抑郁（or =1.68, 95% CI 1.35至2.09;or =3.88, 95% CI 2.58至5.81）或缓解（or =1.56, 95% CI 1.24至1.96;or =1.99, 95% CI 1.27至3.11）的几率更高。在随访期间，轻度或重度经济压力与抑郁和/或焦虑症的发作/复发无关（or =1.08, 95% CI 0.83至1.42;or =1.05, 95% CI 0.64至1.73）。结论：经济压力与抑郁和/或焦虑障碍相关，高于收入的影响。医疗保健和社会服务部门应该警惕这种联系，即使是对高收入家庭也是如此。然而，经济压力和收入与抑郁和/或焦虑障碍的4年发病/复发无关。
Background Previous research has shown socioeconomic inequality in prevalence and onset of depressive disorders. It is not yet clear whether perceived financial strain is associated with depressive and/or anxiety disorders in addition to an objective indicator, such as income. This study examines whether financial strain is associated with the prevalence and onset/recurrence of depressive and/or anxiety disorders, above income.Methods Data are from the Netherlands Study of Depression and Anxiety. Associations between financial strain, income and presence of depressive and/or anxiety disorder at baseline were assessed among 2937 participants (18-65 years). Impact of financial strain and income on 4-year onset/recurrence of depressive and/or anxiety disorders were examined among 1250 participants without a depressive or anxiety disorder at baseline. Depressive and anxiety disorders were determined with the Composite-International-Diagnostic-Interview. Financial strain and income were assessed in an interview.Results Participants with mild or severe financial strain had higher odds of being depressed (OR=1.68, 95% CI 1.35 to 2.09; OR=3.88, 95% CI 2.58 to 5.81) or remitted (OR=1.56, 95% CI 1.24 to 1.96; OR=1.99, 95% CI 1.27 to 3.11) at baseline compared with healthy controls, after adjusting for income. Mild or severe financial strain was not associated with onset/recurrence of depressive and/or anxiety disorders during follow-up (OR=1.08, 95% CI 0.83 to 1.42; OR=1.05, 95% CI 0.64 to 1.73).Conclusions Financial strain was associated with having a depressive and/or anxiety disorder, above the effect of income. Healthcare and social services should be alert to this association, even for higher income households. However, financial strain and income were not related with 4-year onset/recurrence of depressive and/or anxiety disorders.