在加拿大成年人的全国代表性样本中，早期生活逆境、流行病压力和社会支持对精神障碍的相互作用。

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-04-30 DOI:10.1007/s00127-025-02911-6

Dylan Johnson, Ian Colman, Katholiki Georgiades, Mark Wade

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引用次数: 0

摘要

目的：本研究在具有全国代表性的加拿大成年人样本中，研究了先前存在的早期生活逆境（ELA）和当前的社会支持如何与covid - 19特异性大流行压力源相互作用，从而影响精神疾病的风险。方法：参与者（n = 9409）来自心理健康和获得护理调查，这是一项针对COVID大流行后期（2022年3月至7月）加拿大成年人的横断面调查。测量包括大流行压力源（加拿大统计局）、ELA（儿童暴力经历问卷）、社会支持（社会保障量表）和过去12个月的精神问题（世卫组织-儿童健康与发展研究所）。统计分析包括两步逻辑回归模型，对协变量进行调整，对复杂的调查设计进行加权。结果：ELA （aOR = 1.24 [1.15-1.35]-aOR = 1.53[1.39-1.69]）和流行病应激（aOR = 1.18 [1.12-1.25]-aOR = 1.32[1.26-1.39]）预测精神疾病的发生率较高。ELA与抑郁症大流行应激之间存在显著的相互作用（aOR = 0.96[0.93-0.98]），表明ELA水平越高，大流行应激的作用越弱。社会支持与精神问题减少相关（aOR = 0.88 [0.86-0.91]-aOR = 0.97[0.94-0.99]），而大流行应激与精神问题增加相关（aOR = 1.20 [1.15-1.26]-aOR = 1.33[1.27-1.40]）。社会支持与流行病压力对自杀的影响之间的相互作用（aOR = 1.02[1.01-1.03]）表明，在流行病压力存在的情况下，较高水平的社会支持与自杀几率增加有关，尽管这种影响很小，临床意义值得怀疑。结论：ELA和大流行应激增加了精神障碍的可能性，而社会支持具有保护作用。然而，相互作用表明大流行期间精神健康风险之间存在微妙关系。

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Interactions between early-life adversity, pandemic stress, and social support on psychiatric disorders in a nationally representative sample of Canadian adults.

Purpose: This study examined how pre-existing early-life adversity (ELA) and current social support interacted with COVID-specific pandemic stressors in relation to risk of psychiatric disorders in a nationally-representative sample of Canadian adults.

Methods: Participants (n = 9,409) were from the Mental Health and Access to Care Survey, a cross-sectional survey of Canadian adults during later stages of the COVID pandemic (March to July 2022). Measures included pandemic stressors (Statistics Canada), ELA (Childhood Experiences of Violence Questionnaire), social support (Social Provisions Scale), and past 12-month psychiatric problems (WHO-CIDI). Statistical analyses included two-step logistic regression models adjusted for covariates and weighted for complex survey design.

Results: Higher odds of psychiatric problems were predicted by ELA (aOR = 1.24 [1.15-1.35]-aOR = 1.53 [1.39-1.69] across psychiatric disorders) and pandemic stress (aOR = 1.18 [1.12-1.25]-aOR = 1.32 [1.26-1.39] across psychiatric disorders). Significant interactions between ELA and pandemic stress for depression (aOR = 0.96 [0.93-0.98]) suggested an attenuated effect of pandemic stress at higher levels of ELA. Social support was associated with reduced psychiatric problems (aOR = 0.88 [0.86-0.91]-aOR = 0.97 [0.94-0.99]), while pandemic stress was associated with increased psychiatric problems (aOR = 1.20 [1.15-1.26]-aOR = 1.33 [1.27-1.40]). An interaction between social support and pandemic stress for suicidality (aOR = 1.02 [1.01-1.03]) indicated that higher levels of social support were associated with increased odds of suicidality in the presence of pandemic stress, though the effect was small and of questionable clinical significance.

Conclusion: ELA and pandemic stress increased psychiatric disorder likelihood, while social support was protective. However, interactions indicate nuanced relationships in mental health risk during the pandemic.

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.