Age, Period, and Cohort Effects in Psychological Distress in the United States and Canada
Age, Period, and Cohort Effects in Psychological Distress in the United States and Canada
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DOI：
10.1093/aje/kwu029
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发表时间：
2014-05-15
影响因子：
5
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
--
作者：
Keyes, Katherine M.;Nicholson, Ryan;Sareen, Jitender
尽管在美国和其他地方，抑郁和焦虑症状的治疗利用率大幅增加，但仍不清楚心理困扰的潜在人群分布是否会随着时间的推移而发生变化。我们使用来自2个国家超过20年的数据估计了年龄、时期和队列效应，包括1997年至2010年的国家健康访谈调查（n = 447，058）和2000年至2007年的加拿大社区健康调查（n = 125，306）。心理困扰用Kessler心理困扰量表测量。按时期划分，这两个国家的心理困扰程度在2001年最高，在2007年最低。按年龄划分，心理困扰在青春期和40年代末和50年代初最高。按队列，加拿大社区健康调查结果表明，在1922-1925年至1935-1939年出生的人群中，队列效应正在下降（β =-0.36，95%置信区间：-0.45，-0.27），然后在20世纪的剩余时间内，通过1989-1992年，队列效应持续增加（β = 0.49，95%置信区间：0.38，0.61）。全国健康访谈调查数据捕获了较早出生的队列，并表明最早出生的队列效应增加（1912-1914年，β = 0.44，95%置信区间：0.26，0.61）。总之，与本世纪中叶出生的人相比，年龄最大和最近出生的人有更高的平均心理困扰症状，强调了广泛的人口水平透镜对心理健康概念化的重要性。
Although treatment utilization for depression and anxiety symptoms has increased substantially in the United States and elsewhere, it remains unclear whether the underlying population distribution of psychological distress is changing over time. We estimated age, period, and cohort effects using data from 2 countries over more than 20 years, including National Health Interview Surveys from 1997 to 2010 (n = 447,058) and Canadian Community Health Surveys from 2000 to 2007 (n = 125,306). Psychological distress was measured with the Kessler Psychological Distress Scale. By period, both countries showed the highest levels of psychological distress in 2001 and the lowest levels in 2007. By age, psychological distress was highest in adolescence and during the late 40s and early 50s. By cohort, Canadian Community Health Survey results indicated a decreasing cohort effect among those born in 1922-1925 through 1935-1939 (beta = -0.36, 95% confidence interval: -0.45, -0.27) and then a continuously increasing cohort effect during the remainder of the 20th century through 1989-1992 (beta = 0.49, 95% confidence interval: 0.38, 0.61). The National Health Interview Survey data captured earlier-born cohorts and indicated an increased cohort effect for the earliest born (for 1912-1914, beta = 0.44, 95% confidence interval: 0.26, 0.61). In sum, individuals in the oldest and more recently born birth cohorts have higher mean psychological distress symptoms compared with those born in midcentury, underscoring the importance of a broad, population-level lens for conceptualizing mental health.