Associations between neighborhood-level violence and individual mental disorders: Results from the World Mental Health surveys in five Latin American cities

PSYCHIATRY RESEARCH

卷:282

Article

Benjet, C.¹  Sampson, L.²  Yu, S.²  Kessler, R. C.²  Zaslavsky, A.²  Evans-Lacko, S.^3,4  Martins, S. S.⁵  Andrade, L. H.⁶  Aguilar-Gaxiola, S.⁷  Cia, A.⁸  Medina-Mora, M. E.¹  Stagnaro, J. C.⁹  Torres de Galvez, M. Y.¹⁰  Viana, M. C.¹¹  Galea, S.² 

[1] Natl Inst Psychiat Ramon de la Fuente Muniz, Dept Epidemiol & Psychosocial Res, Mexico City, DF, Mexico

[2] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[3] Kings Coll London, Hlth Serv & Populat Res Dept, Inst Psychiat Psychol & Neurosci, London, England

[4] London Sch Econ & Polit Sci, PSSRU, London, England

[5] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA

[6] Univ Sao Paulo, Fac Med, Nucleo Epidemiol Psiquiatria LIM 23, Inst Psiquiatria,Hosp Clin, Sao Paulo, SP, Brazil

[7] UC Davis Hlth Syst, Ctr Reducing Hlth Dispar, Sacramento, CA USA

[8] Anxiety Disorders Ctr, Buenos Aires, DF, Argentina

[9] Univ Buenos Aires, Fac Med, Dept Psiquiatria & Salud Mental, Buenos Aires, DF, Argentina

[10] CES Univ, Medellin, Colombia

[11] Univ Fed Espirito Santo, Dept Social Med, Postgrad Program Publ Hlth, Vitoria, ES, Brazil

关键词: Neighborhood;    Crime;    Internalizing disorder;    Externalizing disorder;    Urban;    Megacities;    Psychiatric disorder;   

DOI  :  10.1016/j.psychres.2019.112607

来源: Elsevier

【 摘 要 】

Rapidly urbanizing areas of Latin America experience elevated but unevenly distributed levels of violence. Extensive research suggests that individual exposure to violence is associated with higher odds of both internalizing (anxiety and mood) and externalizing (substance and intermittent explosive) mental disorders. Less research, however, has focused on how neighborhood-level violence, as an indicator of broader neighborhood contexts, might relate to the mental health of residents, independently of an individual's personal exposure. We used multilevel analyses to examine associations of neighborhood-level violence with individual-level past-year mental disorders, controlling for individual-level violence exposure. We used data from 7,251 adults nested in 83 neighborhoods within five large Latin American cities as part of the WHO World Mental Health Surveys. Accounting for individual-level violence exposure, living in neighborhoods with more violence was associated with significantly elevated odds of individual-level internalizing disorders, but not externalizing disorders. Caution should be exercised when making causal inferences regarding the effects of neighborhood-level violence in the absence of experimental interventions. Nevertheless, neighborhood context, including violence, should be considered in the study of mental disorders. These findings are particularly relevant for rapidly urbanizing areas with high levels of violence, such as Latin America.

【 授权许可】

Free