Received Apr 28; Accepted Apr 8.
Advanced Search Abstract Low socioeconomic status SES is generally associated with high psychiatric morbidity, more disability, and poorer access to health care.
Among psychiatric disorders, depression exhibits a more controversial association with SES. The authors carried out a meta-analysis to evaluate the magnitude, shape, and modifiers of such an association.
The search found 51 prevalence studies, five incidence studies, and four persistence studies meeting the criteria. A random effects model was applied to the odds ratio of the lowest SES group compared with the highest, and meta-regression was used to assess the dose-response relation and the influence of covariates.
A dose-response relation was observed for education and income. Socioeconomic inequality in depression is heterogeneous and varies according to the way psychiatric disorder is measured, to the definition and measurement of SES, and to contextual features such as region and time.
Nonetheless, the authors found compelling evidence for socioeconomic inequality in depression. Strategies for tackling inequality in depression are needed, especially in relation to the course of the disorder.
Received for publication January 22, ; accepted for publication August 5, Low socioeconomic status SES is generally associated with high psychiatric morbidity, disability, and poor access to health care.
In countries where comparable epidemiologic studies have been carried out, the lowest educational group had a higher prevalence of psychiatric morbidity 1.
Poorer coping styles, ongoing life events, stress exposure, and weaker social support are some examples of psychiatric risk factors that are more prevalent in lower SES groups 2. The outcomes of such higher mental morbidity have also been found to be unequally distributed.
For the same level of severity, lower SES groups faced more disabilities 3 and a poorer prognosis 4.
In countries providing less generous welfare support, lower SES groups also faced less favorable access to health care 5 ; whatever the welfare coverage, they were less likely to use specialized mental care 6.
Whereas 17 out of 20 studies examined in a review that included all types of psychiatric disorders 7 found higher rates of overall psychopathology in the lowest social class on average, 2. Only five out of 11 specific studies showed a higher prevalence in the lower SES group average rate ratio of 1.
A more recent review 8 also showed such controversial results for depression, suggesting that inequalities in depression should be further investigated.
Most of the early psychiatric epidemiologic studies shared three methodological weaknesses 9. First, several of the studies only included patients in the sample, making results vulnerable to variations in the help-seeking and referral process Second, they conceptualized psychiatric disorder in general, with poor nomenclature and without adequate criteria for setting the threshold of psychiatric disorder 9 Third, they used symptom-screening instruments that were insufficiently specific, because they mixed a wide range of psycho-physiologic problems as well as true psychiatric disorders 7.
Since the early s, important psychiatric epidemiologic surveys have been carried out on a wider geographic basis. However, they have not yielded consistent results for the direction, strength, or monotonicity of the relation between SES and mental disorder 1.Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between demographic sub-groups.
Mean age of respondents was (range 19–99) years. Females comprised 63 % of the sample, 48 % had not completed secondary education, and 96 % reported at least one existing health condition.
The prevalence rates of depression were significantly higher in females with type 2 diabetes mellitus compared with males with type 2 diabetes mellitus [3–6], varying from a doubled percentage for women than for men and more than three times higher in women compared with men. Sep 04, · This study evaluates the relationship between depression and these sociodemographic factors in the province of Ontario in Canada using the Canadian Community Health Survey, Cycle (CCHS) dataset.
prevalence of depression symptoms among the general population using a reliable screening tool, and to find out if there is any association of certain socio-demographic. The aim was to study correlation between depression (MADRS) and somtisation (BSI) scores, socio-demographic factors influencing depression and somatization scores in various subgroups of depression.
This is a cross sectional study conducted in outpatient department at government general hospital. In addition, since racial/ethnic differences in sociodemographic (other than race/ethnicity),2, 16, 17 health,2, 17– 20 and economic16, 17, 21 characteristics may be entangled in observed depression frequencies,22, 23 we evaluated the influence of such factors .