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Tytuł:
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Associations between subjective social status and DSM-IV mental disorders: results from the World Mental Health surveys.
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Autorzy:
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Scott KM; Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
Al-Hamzawi AO; Department of Medicine, College of Medicine, Al-Qadisia University, Diwania, Iraq.
Andrade LH; Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Borges G; Division of Epidemiological and Psychosocial Research, Department of Intervention Models, National Institute of Psychiatry, Mexico City, Mexico5Department of Health Services, Metropolitan Autonomous University, Mexico City, Mexico.
Caldas-de-Almeida JM; Chronic Diseases Research Center and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Fiestas F; National Institute of Health of Peru, Evidence Generation Research Unit, Lima, Peru.
Gureje O; World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences, and Drug and Alcohol Abuse, Ibadan, Nigeria9Department of Psychiatry, College of Medicine, University of Ibadan, University College Hospital, Ibadan.
Hu C; Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China.
Karam EG; St George Hospital University Medical Center, Balamand University, Institute for Development, Research, Advocacy, Beirut, Lebanon 12Applied Care, Medical Institute for Neuropsychological Disorders, Beirut, Lebanon.
Kawakami N; School of Public Health, University of Tokyo, Tokyo, Japan.
Lee S; Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong.
Levinson D; Mental Health Services, Ministry of Health, Jerusalem, Israel.
Lim CC; Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
Navarro-Mateu F; Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar, Murcia, Spain.
Okoliyski M; National Centre of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria.
Posada-Villa J; Colegio Mayor de Cundinamarca University, Bogota, DC, Colombia.
Torres Y; Salud Mental, Universidad CES, Medellín, Colombia.
Williams DR; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
Zakhozha V; Kiev International Institute of Sociology, Kiev, Ukraine.
Kessler RC; Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
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Źródło:
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JAMA psychiatry [JAMA Psychiatry] 2014 Dec 01; Vol. 71 (12), pp. 1400-8.
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Typ publikacji:
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Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Chicago, IL : American Medical Association, [2013]-
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MeSH Terms:
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Health Surveys*
Social Class*
Anxiety Disorders/*epidemiology
Disruptive, Impulse Control, and Conduct Disorders/*epidemiology
Mood Disorders/*epidemiology
Adolescent ; Adult ; Aged ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Young Adult
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References:
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Grant Information:
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R01 DA016558 United States DA NIDA NIH HHS; U01-MH60220 United States MH NIMH NIH HHS; R03 TW006481 United States TW FIC NIH HHS; U01 MH060220 United States MH NIMH NIH HHS; R13-MH066849 United States MH NIMH NIH HHS; R01 MH070884 United States MH NIMH NIH HHS; R01 MH059575 United States MH NIMH NIH HHS; R01-MH059575 United States MH NIMH NIH HHS; R01 MH069864 United States MH NIMH NIH HHS; R01-MH61905 United States MH NIMH NIH HHS; R01 MH061905 United States MH NIMH NIH HHS; R01-MH069864 United States MH NIMH NIH HHS; K05 DA015799 United States DA NIDA NIH HHS; R03-TW006481 United States TW FIC NIH HHS; R03 TW006481-01 United States TW FIC NIH HHS; R13 MH066849 United States MH NIMH NIH HHS
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Entry Date(s):
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Date Created: 20141030 Date Completed: 20150301 Latest Revision: 20211021
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Update Code:
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20240104
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PubMed Central ID:
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PMC5315238
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DOI:
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10.1001/jamapsychiatry.2014.1337
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PMID:
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25354080
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Importance: The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures, such as educational level, income, and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture the perception of relative social status, but to our knowledge, there have been no studies of associations between SSS and mental disorders.
Objectives: To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS.
Design, Setting, and Participants: Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, and the Middle East (N=56,085). Subjective social status was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, educational level, and occupation. Scores on the 1 to 10 SSS scale were categorized into 4 categories: low (scores 1-3), low-mid (scores 4-5), high-mid (scores 6-7), and high (scores 8-10). Objective social status was assessed with a wide range of fine-grained objective indicators of income, educational level, and occupation.
Main Outcomes and Measures: The Composite International Diagnostic Interview assessed the 12-month prevalence of 16 DSM-IV mood, anxiety, and impulse control disorders.
Results: The weighted mean survey response rate was 75.2% (range, 55.1%-97.2%). Graded inverse associations were found between SSS and all 16 mental disorders. Gross odds ratios (lowest vs highest SSS categories) in the range of 1.8 to 9.0 were attenuated but remained significant for all 16 disorders (odds ratio, 1.4-4.9) after adjusting for OSS indicators. This pattern of inverse association between SSS and mental disorders was significant in 14 of 18 individual countries, and in low-, middle-, and high-income country groups but was significantly stronger in high- vs lower-income countries.
Conclusions and Relevance: Significant inverse associations between SSS and numerous DSM-IV mental disorders exist across a wide range of countries even after comprehensive adjustment for OSS. Although it is unclear whether these associations are the result of social selection, social causation, or both, these results document clearly that research relying exclusively on standard OSS measures underestimates the steepness of the social gradient in mental disorders.
