社会贫困和人口密度轨迹在精神疾病诊断之前和之后
Yanakan Logeswaran1, Jennifer Dykxhoorn1,2, Christina Dalman3,4
1PsyLife Group, Division of Psychiatry, University College London, London, United Kingdom.
JAMA psychiatry
|September 6, 2023
概括
儿童暴露于贫困和人口密集增加了精神病的风险. 上升的流动性可以减轻这种情况,但患有严重精神疾病的个人往往在诊断后仍留在贫困地区.
科学领域:
- 精神病学是一个精神病学.
- 环境流行病学环境流行病学
- 健康的社会决定因素
背景情况:
- 患有精神病的人通常居住在贫困,人口密的地区,但因果关系尚不清楚.
- 了解环境因素对心理健康的影响对于公共卫生倡议至关重要.
研究的目的:
- 调查社会经济贫困和人口密度在诊断前和诊断后的轨迹以及精神病和非精神病双相情感障碍的风险之间的关联.
- 确定环境暴露是否是严重精神疾病的原因或后果.
主要方法:
- 瑞典的一项嵌套病例对照研究包括1982年至2001年间出生的人,他们被诊断患有精神病或非精神病双相情感障碍.
- 从出生到14岁,从诊断到队列退出,每年评估邻居贫困和人口密度.
- 基于组的轨迹建模和后勤回归被用来分析环境暴露和精神疾病结果之间的关联.
主要成果:
- 在成长过程中,更高的贫困和人口密度暴露与精神疾病风险增加有关.
- 上升的社会经济流动到较不贫困的社区与居住在最不贫困地区的风险相似.
- 与对照人群相比,被诊断患有精神病的个人在诊断后更有可能留在或搬到更贫困的地区.
结论:
- 儿童遭受社会经济贫困的暴露与严重精神疾病的风险增加有关.
- 诊断后的社会不动是一个重大问题,受影响的个体不成比例地留在贫困环境中.
- 公共卫生干预和严重精神疾病的治疗应根据需要在贫困地区战略定位.
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