Abstract
Objectives
: There is a well-established association between gender and the prevalence of mental illness. The objective of this study was to determine whether gender also influences the timing of remission from illness. The regression analysis undertaken considered remission in terms of all ICD-9 mental disorders (codes 290-314). This analysis compares males and females on average length of treatment for mental illness and examines whether any gender differences in remission are generalized or disorder specific.
Methods
: The statistical analysis was based on longitudinal (1990-2001) administrative data on 5,118 females and 2,470 males. The target population represented all individuals with an ICD-9 diagnosis of mental illness who were treated through the Medical Services Plan in British Columbia. The regression analysis used the generalized estimating equations method to model differences in length of treatment.
Results
: There was a non-significant bivariate relation between gender and the timing of remission from mental illness. However, the multivariate findings demonstrated that a significant gender effect on remission emerges after controls were introduced for demographic and socio-economic characteristics. In particular, the timing of remission was somewhat longer for females. This effect was generalized and not restricted to specific illnesses.
Conclusions
: The emergence of a significant effect after considering demographic and socio-economic characteristics suggests that a social disadvantage within the male sample (more single males) was suppressing a small negative effect of female gender on the timing of remission. In other words, a social disadvantage among males concealed an unexplained female disadvantage in remission.
Key words: Gender, remission, mental health
Résumé
Objectifs
: Il existe un lien confirmé entre le sexe et la prévalence des maladies mentales. Nous avons cherché à déterminer si le sexe influençait aussi le moment des rémissions de ce genre de maladies. Au moyen d’une analyse de régression, nous avons étudié les rémissions de tous les troubles mentaux énumérés dans la CIM-9 (codes 290 à 314). L’analyse comparait la durée moyenne des traitements pour maladie mentale chez les hommes et les femmes afin de déceler d’éventuels écarts entre les sexes dans les rémissions et de déterminer si ces écarts étaient généralisés ou propres à certains troubles.
Méthode
: Notre analyse statistique était fondée sur les données administratives longitudinales (1990-2001) de 5 118 femmes et de 2 470 hommes. La population cible englobait toutes les personnes présentant un diagnostic de maladie mentale selon la CIM-9 qui avaient été traitées par le régime de santé de la Colombie-Britannique. Dans l’analyse de régression, nous avons utilisé la méthode des équations d’estimation généralisées pour modéliser les écarts dans la durée des traitements.
Résultats
: Nous observons une relation bivariée non significative entre le sexe et le moment des rémissions des maladies mentales. Cependant, les résultats de l’analyse multivariée montrent l’émergence d’un effet sexospécifique significatif après l’introduction de variables de contrôle démographiques et socioéconomiques. En particulier, les rémissions sont un peu plus tardives chez les femmes. Cet effet est généralisé: il ne se limite pas à certaines maladies.
Conclusion
: L’émergence d’un effet significatif lorsqu’on tient compte de variables démographiques et socioéconomiques donne à penser que l’existence d’un désavantage social dans l’échantillon masculin (composé de plus de célibataires) a annulé un léger effet néfaste dans le moment des rémissions chez les femmes. Autrement dit, un désavantage social chez les hommes masquait un désavantage inexpliqué sur le plan des rémissions chez les femmes.
Mots clés: sexospécificité, rémission, santé mentale
Footnotes
Acknowledgements: The authors acknowledge Chi Zheng and Ruth Kampen for their research assistance and the Canadian Institutes of Health Research, Institute of Neurosciences, Mental Health, and Addiction, for financial support.
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