Manuel Gardea-Resendez, Manuel Fuentes-Salgado, Francisco Romo-Nava, Miguel L Prieto, David J Bond, Aysegul Ozerdem, Hannah K Betcher, Katherine M Moore, Melissa Solares-Bravo, Mete Ercis, Alessandro Miola, Jorge A Sanchez-Ruiz, Marin Veldic, Balwinder Singh, Alfredo B Cuellar-Barboza, Brandon J Coombes, Joanna M Biernacka, Susan L McElroy, Monica J Taylor-Desir, Mark A Frye
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引用次数: 0
摘要
目的:探讨健康社会决定因素(social factors of health, SDoH)应激在双相情感障碍(bipolar disorder, BD)病程中的临床影响,并探讨SDoH应激认可的潜在性别差异。方法:2280名I型或II型双相障碍患者(62%为女性,67.5%为BD-I型)参加梅奥诊所双相障碍生物库,在研究入组前12个月完成了一份评估正价和负价压力源的问卷。以6个负性应激源作为SDoH的替代指标。我们使用广义线性模型来检验SDoH应激源与疾病严重程度标记之间的关联,以及通过包括一个相互作用项来检验性别之间的潜在差异。结果:在调整了年龄、性别和招募地点后,sdoh相关压力源与男性和女性更严重的病程显著相关。除失业率外,妇女更多地报告了与特别保健工作有关的压力(即缺乏家庭支持、经济问题、医疗保险和获得服务的问题)。结论:研究发现,在特定SDoH压力源的认可和特定疾病严重程度标记的患病率方面,性别差异显著;然而,它没有直接测试SDoH性别差异与疾病严重程度标志物之间的预测关系。未来旨在实现精神卫生保健健康公平的研究应继续评估健康压力源的社会决定因素,并纳入性别观点,以更好地了解其对双相情感障碍的影响。
A Cross-Sectional Analysis of Social Determinants of Health in Bipolar Disorder: Exploring Gender-Related Differences.
Objectives: To explore the clinical impact of social determinants of health (SDoH) stress in bipolar disorder (BD) course of illness and to explore potential gender differences in SDoH stress endorsement.
Methods: 2280 individuals living with BD type I or II (62% women; 67.5% BD-I) participating in the Mayo Clinic Bipolar Biobank who completed a questionnaire assessing positive and negative-valent stressors in the 12 months prior to study enrollment were included for this analysis. Six negative stressors were used as proxies of SDoH. Generalized linear models were used to test the association between SDoH stressors and markers of illness severity as well as potential differences by sex by including an interaction term.
Results: After adjusting for age, sex, and recruitment site, SDoH-related stressors were significantly associated with a more severe course of illness in both men and women. Except for unemployment rates, women reported more frequently SDoH-related stress (i.e., lack of family support, financial problems, health coverage and access problems).
Conclusions: The study found significant gender differences in both the endorsement of specific SDoH stressors and in the prevalence of specific illness severity markers; however, it did not directly test the predictive relationship between gender differences in SDoH and illness severity markers. Future studies aiming to achieve health equity in mental health care should continue assessing social determinants of health stressors, incorporating a gender perspective to better understand their influence on bipolar disorder.
期刊介绍:
Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas:
biochemistry
physiology
neuropsychopharmacology
neuroanatomy
neuropathology
genetics
brain imaging
epidemiology
phenomenology
clinical aspects
and therapeutics of bipolar disorders
Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders.
The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.