The global financial crisis emerging in 2008 struck Greece especially hard, whereas Scandinavian countries were less affected. This has created a unique opportunity to study the long-term effect of community stress on populations. Increasing frequencies of mental health issues and poorer perceived health among the Greek population have been reported. The physiological marker of long-term stress, cortisol in hair, is applied in this study together with measures of perceived health and stress, depression and anxiety. Our aim was to study self-reported and physiological stress, perceived health, including mental health, in the general population of Greece compared to Scandinavia, in order to assess long-term effects of the economic crisis on these parameters. A cross-sectional comparative study of adult (18–65 years) Primary Health Care visitors from semi-rural areas in Greece (n = 84) and Scandinavia (n = 140). Data collection was performed in 2012, and encompassed a questionnaire with a variety of health and stress indicators as well as hair samples for analyzes of cortisol levels. The Greek sample reported significantly poorer overall health (p < 0.0001) than the Scandinavians and a significantly higher perceived stress (p < 0.0001). The Greeks were also less hopeful of the future (p < 0.0001), and to a larger extent fulfilled the HAD criteria for depression (p < 0.0001) and anxiety (p = 0.002). The strongest predictors explaining ill health in logistic regressions were being Greek (p = 0.001) and feeling hopeless about the future p = 0.001, OR = 6.00 (CI 2.10–14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p < 0.0001) and medium (p = 0.0001), as well as medium depression (p = 0.02). Greek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, but this was not reflected in higher cortisol levels. The findings presented here, identify possible adverse long-term effects of the economic crisis in the examined Greek population that are not seen in the Scandinavian cohort. These differences may also be interpreted against the background of socio-cultural differences in the northern and south-eastern corners of Europe.

中文翻译：

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欧洲两个角落的初级保健访客的压力和感知健康：斯堪的纳维亚和希腊

2008年爆发的全球金融危机对希腊的打击尤其严重，而斯堪的纳维亚国家受影响较小。这为研究社区压力对人口的长期影响创造了独特的机会。据报道，希腊人口中心理健康问题的发生频率越来越高，健康状况越来越差。长期压力的生理标志，头发中的皮质醇，与感知健康和压力、抑郁和焦虑的措施一起应用于这项研究。我们的目的是研究与斯堪的纳维亚半岛相比，希腊普通人群的自我报告和生理压力、感知健康，包括心理健康，以评估经济危机对这些参数的长期影响。对来自希腊 (n = 84) 和斯堪的纳维亚 (n = 140) 半农村地区的成人（18-65 岁）初级保健访问者的横断面比较研究。数据收集于 2012 年进行，包括一份包含各种健康和压力指标的问卷以及用于分析皮质醇水平的头发样本。希腊样本报告的整体健康状况 (p < 0.0001) 明显低于斯堪的纳维亚人，感知压力明显较高 (p < 0.0001)。希腊人对未来的希望也不大 (p < 0.0001)，并且在更大程度上满足了抑郁症 (p < 0.0001) 和焦虑症 (p = 0.002) 的 HAD 标准。在逻辑回归中解释健康不佳的最强预测因素是希腊人 (p = 0.001) 和对未来感到绝望 p = 0.001，OR = 6.00 (CI 2.10–14.88)。逻辑回归中高感知压力的强预测因子是焦虑：高 (p < 0.0001) 和中等 (p = 0.0001)，以及中等抑郁 (p = 0.02)。与斯堪的纳维亚人相比，希腊成年初级卫生保健访问者对他们的健康的看法更为消极，包括抑郁、焦虑和对未来的希望较低。希腊人也报告了更高的感知压力，但这并没有反映在更高的皮质醇水平上。此处介绍的研究结果确定了经济危机对所检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。0.0001) 和中度 (p = 0.0001)，以及中度抑郁 (p = 0.02)。与斯堪的纳维亚人相比，希腊成年初级卫生保健访问者对他们的健康的看法更为消极，包括抑郁、焦虑和对未来的希望较低。希腊人也报告了更高的感知压力，但这并没有反映在更高的皮质醇水平上。此处介绍的研究结果确定了经济危机对所检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。0.0001) 和中度 (p = 0.0001)，以及中度抑郁 (p = 0.02)。与斯堪的纳维亚人相比，希腊成年初级卫生保健访问者对他们的健康的看法更为消极，包括抑郁、焦虑和对未来的希望较低。希腊人也报告了更高的感知压力，但这并没有反映在更高的皮质醇水平上。此处介绍的研究结果确定了经济危机对所检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。与斯堪的纳维亚人相比，希腊成年初级卫生保健访问者对他们的健康的看法更为消极，包括抑郁、焦虑和对未来的希望较低。希腊人也报告了更高的感知压力，但这并没有反映在更高的皮质醇水平上。此处介绍的研究结果确定了经济危机对所检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。与斯堪的纳维亚人相比，希腊成年初级卫生保健访问者对他们的健康的看法更为消极，包括抑郁、焦虑和对未来的希望较低。希腊人也报告了更高的感知压力，但这并没有反映在更高的皮质醇水平上。此处介绍的研究结果确定了经济危机对所检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。确定经济危机对被检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。确定经济危机对被检查的希腊人口可能产生的不利长期影响，而这些影响在斯堪的纳维亚人群中是看不到的。这些差异也可以在欧洲北部和东南角的社会文化差异背景下进行解释。