Abstract
Study objective: To assess which indicators of socioeconomic status are associated with an increased prevalence of common mental disorders.
Design: Cross sectional household survey.
Setting: Santiago, Chile.
Participants: Random sample of adults aged 16–65 residing in private households.
Main results: Less education (odds ratio 2.44, 95% confidence intervals 1.50 to 3.97), a recent income decrease (odds ratio 2.14, 1.70 to 2.70), and poor housing (odds ratio 1.53, 1.05 to 2.23), were the only socioeconomic status variables that remained significantly associated with an increased prevalence of common mental disorders after adjustments. The prevalence of common mental disorders was also higher among people with manual unskilled occupations, overcrowded housing, and lower per capita income but these associations disappeared after adjustment for other explanatory and confounding variables.
Conclusions: There is a strong, inverse, and independent association between education and common mental disorders. However, income was not associated with the prevalence of common mental disorders, after adjusting for other socioeconomic variables. Similar results have been found in other Latin American studies but British studies tend to find the opposite, that income but not education is associated with common mental disorders. Understanding the impact of socioeconomic factors on mental health requires research in poor as well as rich countries.
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- Almeida-Filho N., Mari J. de J., Coutinho E., França J. F., Fernandes J., Andreoli S. B., Busnello E. D. Brazilian multicentric study of psychiatric morbidity. Methodological features and prevalence estimates. Br J Psychiatry. 1997 Dec;171:524–529. doi: 10.1192/bjp.171.6.524. [DOI] [PubMed] [Google Scholar]
- Andrews G., Peters L. The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiol. 1998 Feb;33(2):80–88. doi: 10.1007/s001270050026. [DOI] [PubMed] [Google Scholar]
- Araya R., Rojas G., Fritsch R., Acuña J., Lewis G. Common mental disorders in Santiago, Chile: prevalence and socio-demographic correlates. Br J Psychiatry. 2001 Mar;178:228–233. doi: 10.1192/bjp.178.3.228. [DOI] [PubMed] [Google Scholar]
- Araya R., Wynn R., Leonard R., Lewis G. Psychiatric morbidity in primary health care in Santiago, Chile. Preliminary findings. Br J Psychiatry. 1994 Oct;165(4):530–533. doi: 10.1192/bjp.165.4.530. [DOI] [PubMed] [Google Scholar]
- Canino G. J., Bird H. R., Shrout P. E., Rubio-Stipec M., Bravo M., Martinez R., Sesman M., Guevara L. M. The prevalence of specific psychiatric disorders in Puerto Rico. Arch Gen Psychiatry. 1987 Aug;44(8):727–735. doi: 10.1001/archpsyc.1987.01800200053008. [DOI] [PubMed] [Google Scholar]
- Davey Smith G., Hart C., Hole D., MacKinnon P., Gillis C., Watt G., Blane D., Hawthorne V. Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Community Health. 1998 Mar;52(3):153–160. doi: 10.1136/jech.52.3.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacob K. S., Everitt B. S., Patel V., Weich S., Araya R., Lewis G. H. The comparison of latent variable models of non-psychotic psychiatric morbidity in four culturally diverse populations. Psychol Med. 1998 Jan;28(1):145–152. doi: 10.1017/s0033291797005710. [DOI] [PubMed] [Google Scholar]
- Jenkins R., Lewis G., Bebbington P., Brugha T., Farrell M., Gill B., Meltzer H. The National Psychiatric Morbidity surveys of Great Britain--initial findings from the household survey. Psychol Med. 1997 Jul;27(4):775–789. doi: 10.1017/s0033291797005308. [DOI] [PubMed] [Google Scholar]
- Kahn R. S., Wise P. H., Kennedy B. P., Kawachi I. State income inequality, household income, and maternal mental and physical health: cross sectional national survey. BMJ. 2000 Nov 25;321(7272):1311–1315. doi: 10.1136/bmj.321.7272.1311. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kessler R. C., McGonagle K. A., Zhao S., Nelson C. B., Hughes M., Eshleman S., Wittchen H. U., Kendler K. S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8–19. doi: 10.1001/archpsyc.1994.03950010008002. [DOI] [PubMed] [Google Scholar]
- Lewis G., Araya R. I. Is the General Health Questionnaire (12 item) a culturally biased measure of psychiatric disorder? Soc Psychiatry Psychiatr Epidemiol. 1995 Jan;30(1):20–25. doi: 10.1007/BF00784430. [DOI] [PubMed] [Google Scholar]
- Lewis G., Bebbington P., Brugha T., Farrell M., Gill B., Jenkins R., Meltzer H. Socioeconomic status, standard of living, and neurotic disorder. Lancet. 1998 Aug 22;352(9128):605–609. doi: 10.1016/S0140-6736(98)04494-8. [DOI] [PubMed] [Google Scholar]
- Lewis G., Pelosi A. J., Araya R., Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992 May;22(2):465–486. doi: 10.1017/s0033291700030415. [DOI] [PubMed] [Google Scholar]
- Ludermir A. B., Lewis G. Links between social class and common mental disorders in Northeast Brazil. Soc Psychiatry Psychiatr Epidemiol. 2001 Mar;36(3):101–107. doi: 10.1007/s001270050297. [DOI] [PubMed] [Google Scholar]
- Mackenbach Johan P. Income inequality and population health. BMJ. 2002 Jan 5;324(7328):1–2. doi: 10.1136/bmj.324.7328.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murray C. J., Lopez A. D. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997 May 24;349(9064):1498–1504. doi: 10.1016/S0140-6736(96)07492-2. [DOI] [PubMed] [Google Scholar]
- Patel V., Araya R., de Lima M., Ludermir A., Todd C. Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med. 1999 Dec;49(11):1461–1471. doi: 10.1016/s0277-9536(99)00208-7. [DOI] [PubMed] [Google Scholar]
- Patel V., Sumathipala A. International representation in psychiatric literature: survey of six leading journals. Br J Psychiatry. 2001 May;178:406–409. doi: 10.1192/bjp.178.5.406. [DOI] [PubMed] [Google Scholar]
- Veijola J., Puukka P., Lehtinen V., Moring J., Lindholm T., Väisänen E. Sex differences in the association between childhood experiences and adult depression. Psychol Med. 1998 Jan;28(1):21–27. doi: 10.1017/s0033291797006089. [DOI] [PubMed] [Google Scholar]
- Weich S., Lewis G. Poverty, unemployment, and common mental disorders: population based cohort study. BMJ. 1998 Jul 11;317(7151):115–119. doi: 10.1136/bmj.317.7151.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wise L. A., Zierler S., Krieger N., Harlow B. L. Adult onset of major depressive disorder in relation to early life violent victimisation: a case-control study. Lancet. 2001 Sep 15;358(9285):881–887. doi: 10.1016/S0140-6736(01)06072-X. [DOI] [PubMed] [Google Scholar]