Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, 171 76 Stockholm, Sweden.
J Affect Disord. 2011 Nov;134(1-3):160-7. doi: 10.1016/j.jad.2011.05.024.
There is limited evidence whether the association between low socioeconomic status and risk of common mental disorders varies with symptom severity, type of socioeconomic indicator or gender.
A population-based survey was conducted among a random sample of Stockholm County residents aged 18-84 years in 2002. Respondents were reassessed via a follow-up questionnaire in 2007. Participants in both surveys (n = 23794) were categorized according to socioeconomic status at baseline and followed up for onset of psychological distress (according to the twelve-item general health questionnaire) and depression (according to health data registers). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Occupational class was not associated with risk of psychological distress, regardless of severity or gender. Occupational class was strongly associated with onset of depression in men (OR 3.0 [95% CI 1.5-5.9], comparing unskilled manual workers with higher non-manual workers) but not women. Income was associated with risk of onset of all outcomes, and risks increased with symptom severity. Belonging to the highest household income category was particularly protective of depression in women. Education was unrelated to either outcome in men and women overall.
Retention rate at follow-up was 76% and depression was ascertained via health service use.
Low socioeconomic position is associated with onset of depression but not mild distress. Attributes of occupational class and household income may be respectively more relevant for the development of depression in men and women.
低社会经济地位与常见精神障碍风险之间的关联是否因症状严重程度、社会经济指标类型或性别而异，证据有限。
2002 年在斯德哥尔摩县进行了一项基于人群的调查，随机抽取了 18-84 岁的居民作为样本。在 2007 年通过后续问卷对受访者进行了重新评估。在两次调查中（n=23794），根据基线时的社会经济地位对参与者进行分类，并对心理困扰（根据 12 项一般健康问卷）和抑郁（根据健康数据登记）的发病情况进行随访。使用逻辑回归计算比值比（OR）和 95%置信区间（CI）。
职业阶层与心理困扰的发病风险无关，无论严重程度或性别如何。职业阶层与男性抑郁发病风险密切相关（OR 3.0 [95%CI 1.5-5.9]，与非熟练体力劳动者相比，高非体力劳动者），但与女性无关。收入与所有结果的发病风险相关，风险随症状严重程度的增加而增加。属于最高家庭收入类别的人对女性抑郁的发病风险具有特别的保护作用。教育与男性和女性的总体结果均无关。
随访时的保留率为 76%，且抑郁通过卫生服务使用来确定。
低社会经济地位与抑郁发病有关，但与轻度困扰无关。职业阶层和家庭收入的特征可能分别与男性和女性抑郁的发展更为相关。
