Summary
This is a study of the relationship between variations, over time, in mental hospital admissions, and concommitant variations in economic conditions. The research hypothesis is that during economically depressed periods mental hospital admissions increase and during economically prosperous periods they decrease. Theoretically, it is a study of a relationship between changes over time in the structure of the economy and changes in the distribution of mental illness in a population.
We find that fluctuations in mental hospital admissions show strong inverse correlations with fluctuations in the employment index in New York State over the period 1910 to 1960. The data reveal, however, that subgroups among the hospitalized population exhibit grossly different patterns of reaction to economic changes. In fact, without segregating the population of admissions according to differential risk of exposure to stress during economic changes, it may not be possible to observe this relationship, For reasons not yet well understood, risk of exposure to economic stress appears to vary with diagnostic category of illness and socioeconomic status.
Résumé
Il s'agit d'une étude des relations entre les variations, dans le temps, des admissions dans les hopitaux psychiatriques et les variations correspondantes des conditions économiques. L'hypothèse de la recherche est qu'en période de basse conjoncture économique les admissions en hôpital psychiatrique augmentent, tandis qu'en période de haute conjoncture économique elles diminuent. Du point de vue théorique, il s'agit d'une étude de la relation entre les changements, dans le temps, dans la structure de l'économie et les changements dans la distribution de la maladie mentale dans la population. Nous avons trouvé que les fluctuations des admissions en hôpital psychiatrique sont nettement inversement proportionnelles aux fluctuations de l'«index d'emploi» dans l'Etat de New York pendant la période 1910–1960. Les données révèlent cependant que, dans la population hospitalisée, les sous-groupes font montre, à l'égard des changements économiques, de types de réactions qui différent de façon flagrante. En effet, si l'on ne classait pas la population d'admissions selon le risque différentiel d'exposition au stress lors de changements économiques, il ne serait pas possible d'observer cette relation. Pour des raisons qui ne sont pas encore bien comprises, le risque d'exposition au stress économique semble varier avec la catégorie diagnostique de la maladie et le status socio-économique.
Zusammenfassung
Die Untersuchung beschäftigt sich mit der Beziehung zwischen Krankenhausaufnahmeziffern und Wirtschaftslage. Es wird die Arbeitshypothese gebildet, daß in Perioden einer Wirtschaftsdepression die psychiatrischen Krankenhausaufnahmen ansteigen und daß sie in Konjunkturzeiten albfallen. Theoretisch gesehen, handelt es sich also um eine Untersuchung über Zusammenhänge zwischen zeitlichen Veränderungen der ökonomischen Struktur und Wandlungen der Verteilung psychischer Krankheiten in einer Bevölkerung.
Wir fanden Veränderungen der Hospitalaufnahmen, welche in einer inversen Korrelation zu den Änderungen des Beschäftigungsindex stehen; die Untersuchung erstreckte sich über den Staat New York für die Zeitstrecke 1910–1960. Aus den Daten ergibt sich aber, daß bestimmte Untergruppen der Hospitalisierten ganz verschiedenartig auf ökonomische Veränderungen reagierten. Bevor man nicht das Belastungsrisiko der jeweils aufgenommenen Patienten für den wirtschaftlichen Stress differenzierend bestimmt, wird keine Klarheit über die aufgewiesenen Beziehungen Zustandekommen. Aus noch undurchsichtigen Gründen variiert das Stress-Risiko mit der diagnostischen Einordnung und dem sozioökonomischen Status.
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Brenner, M.H. Economic change and mental hospitalization: New York State, 1910–1960. Soc Psychiatry 2, 180–188 (1967). https://doi.org/10.1007/BF00578054
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DOI: https://doi.org/10.1007/BF00578054