七个国家的婚姻状况与抑郁症之间的关联和因果中介作用

IF 15.8 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Xiaobing Zhai, Henry H. Y. Tong, Chi Kin Lam, Abao Xing, Yuyang Sha, Gang Luo, Weiyu Meng, Junfeng Li, Miao Zhou, Yangxi Huang, Ling Shing Wong, Cuicui Wang, Kefeng Li
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引用次数: 0

摘要

抑郁症是全球公共卫生面临的一项重大挑战,而婚姻状况被认为是一个潜在的风险因素。然而,以往对这一关联的调查主要集中在西方样本中,存在很大的异质性。我们的研究旨在通过大规模的两阶段跨国分析,研究不同文化背景国家的婚姻状况与抑郁症状之间的关联。我们使用了来自美国、英国、墨西哥、爱尔兰、韩国、中国和印度尼西亚等七个国家(106556 名横断面参与者和 20865 名纵向参与者)的具有全国代表性、去身份化的个人层面数据,这些数据代表了约 5.41 亿成年人。随访时间从 4 年到 18 年不等。我们的分析表明,在所有国家中,未婚者出现抑郁症状的风险高于已婚者(汇总赔率为 1.86;95% 置信区间 (CI),1.61-2.14)。然而,这种风险的大小受国家、性别和教育水平的影响,西方国家相对于东方国家(β = 0.36; 95% CI, 0.16-0.56; P <0.001)、男性相对于女性(β = 0.25; 95% CI, 0.003-0.47; P = 0.047)以及教育程度较高相对于较低者(β2 = 0.34; 95% CI, 0.11-0.56; P = 0.003)的风险更大。此外,在丧偶、离婚/分居和单身的中国人、韩国人和墨西哥人中,饮酒对日后抑郁症状风险的增加具有因果中介作用(均为 P < 0.001)。同样,在中国和墨西哥的单身参与者中,吸烟也被认为是一个因果中介因素,并且在自举重采样验证和敏感性分析中结果保持不变。我们的跨国分析表明,未婚人士患抑郁症的风险可能更大,任何降低这种风险的努力都应考虑文化背景、性别、教育程度和药物使用的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association and causal mediation between marital status and depression in seven countries

Association and causal mediation between marital status and depression in seven countries

Depression represents a significant global public health challenge, and marital status has been recognized as a potential risk factor. However, previous investigations of this association have primarily focused on Western samples with substantial heterogeneity. Our study aimed to examine the association between marital status and depressive symptoms across countries with diverse cultural backgrounds using a large-scale, two-stage, cross-country analysis. We used nationally representative, de-identified individual-level data from seven countries, including the USA, the UK, Mexico, Ireland, Korea, China and Indonesia (106,556 cross-sectional and 20,865 longitudinal participants), representing approximately 541 million adults. The follow-up duration ranged from 4 to 18 years. Our analysis revealed that unmarried individuals had a higher risk of depressive symptoms than their married counterparts across all countries (pooled odds ratio, 1.86; 95% confidence interval (CI), 1.61–2.14). However, the magnitude of this risk was influenced by country, sex and education level, with greater risk in Western versus Eastern countries (β = 0.36; 95% CI, 0.16–0.56; P < 0.001), among males versus females (β = 0.25; 95% CI, 0.003–0.47; P = 0.047) and among those with higher versus lower educational attainment (β2 = 0.34; 95% CI, 0.11–0.56; P = 0.003). Furthermore, alcohol drinking causally mediated increased later depressive symptom risk among widowed, divorced/separated and single Chinese, Korean and Mexican participants (all P < 0.001). Similarly, smoking was as identified as a causal mediator among single individuals in China and Mexico, and the results remained unchanged in the bootstrap resampling validation and the sensitivity analyses. Our cross-country analysis suggests that unmarried individuals may be at greater risk of depression, and any efforts to mitigate this risk should consider the roles of cultural context, sex, educational attainment and substance use.

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来源期刊
ACS Nano
ACS Nano 工程技术-材料科学:综合
CiteScore
26.00
自引率
4.10%
发文量
1627
审稿时长
1.7 months
期刊介绍: ACS Nano, published monthly, serves as an international forum for comprehensive articles on nanoscience and nanotechnology research at the intersections of chemistry, biology, materials science, physics, and engineering. The journal fosters communication among scientists in these communities, facilitating collaboration, new research opportunities, and advancements through discoveries. ACS Nano covers synthesis, assembly, characterization, theory, and simulation of nanostructures, nanobiotechnology, nanofabrication, methods and tools for nanoscience and nanotechnology, and self- and directed-assembly. Alongside original research articles, it offers thorough reviews, perspectives on cutting-edge research, and discussions envisioning the future of nanoscience and nanotechnology.
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