Socioeconomic inequalities in common mental disorders and psychotherapy treatment in the UK between 1991 and 2009

BackgroundInequality in health and treatment of disease across socioeconomic status groups is a major public health issue.AimsTo examine differences in socioeconomic status in common mental disorders and use of psychotherapy provided by the public and private sector in the UK between 1991 and 2009.MethodDuring these years, 28 054 men and women responded to annual surveys by the nationally representative, population-based British Household Panel Survey (on average 7 measurements per participant; 207 545 person-observations). In each year, common mental disorders were assessed with the self-reported 12-item General Health Questionnaire and socioeconomic status was assessed on the basis of household income, occupational status and education.ResultsHigher socioeconomic status was associated with lower odds of common mental disorder (highest v. lowest household income quintile odds ratio (OR) 0.88, 95% CI 0.82–0.94) and of being treated by publicly provided psychotherapy (OR = 0.43, 95% CI 0.34–0.55), but higher odds of being a client of private psychotherapy (OR = 3.33, 95% CI 2.36–4.71). The status difference in publicly provided psychotherapy treatment was more pronounced at the end of follow-up (OR = 0.36, 95% CI 0.23–0.56, in 2005–2009) than at the beginning of the follow-up period (OR =0.96, 95% CI 0.66–1.39, in 1991–1994; time interaction P<0.001). The findings for occupational status and education were similar to those for household income.ConclusionsThe use of publicly provided psychotherapy has improved between 1991 and 2009 among those with low socioeconomic status, although social inequalities in common mental disorders remain.

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Socio-economic position and common mental disorders

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.014449 ◽

2006 ◽

Vol 189 (2) ◽

pp. 109-117 ◽

Cited By ~ 86

Author(s):

Petros Skapinakis ◽

Scott Weich ◽

Glyn Lewis ◽

Nicola Singleton ◽

Ricardo Araya

Keyword(s):

Mental Disorders ◽

Common Mental Disorders ◽

Common Mental Disorder ◽

Psychiatric Morbidity ◽

Population Sample ◽

Diagnostic Categories ◽

Longitudinal Association ◽

Economic Position ◽

The Uk

BackgroundIndividuals in lower socio-economic groups have an increased prevalence of common mental disorders.AimsTo investigate the longitudinal association between socio-economic position and common mental disorders in a general population sample in the UK.MethodParticipants (n=2406) were assessed at two time points 18 months apart with the Revised Clinical Interview Schedule. The sample was stratified into two cohorts according to mental health status at baseline.ResultsNone of the socio-economic indicators studied was significantly associated with an episode of common mental disorder at follow-up after adjusting for baseline psychiatric morbidity. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both cohorts.ConclusionsThese findings support the view that apart from objective measures of socio-economic position, more subjective measures might be equally important from an aetiological or clinical perspective.

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Common mental disorders, subthreshold symptoms and disability: longitudinal study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.079244 ◽

2010 ◽

Vol 197 (5) ◽

pp. 411-412 ◽

Cited By ~ 38

Author(s):

Dheeraj Rai ◽

Petros Skapinakis ◽

Nicola Wiles ◽

Glyn Lewis ◽

Ricardo Araya

Keyword(s):

Mental Disorders ◽

Functional Disability ◽

Psychiatric Symptoms ◽

Common Mental Disorders ◽

Psychiatric Morbidity ◽

Diagnostic Categories ◽

Icd 10 ◽

The Uk ◽

Aggregate Burden

SummaryIn a representative sample of the UK population we found that common mental disorders (as a group and in ICD–10 diagnostic categories) and subthreshold psychiatric symptoms at baseline were both independently associated with new-onset functional disability and significant days lost from work at 18-month follow-up. Subthreshold symptoms contributed to almost half the aggregate burden of functional disability and over 32 million days lost from work in the year preceding the study. Leaving these symptoms unaccounted for in surveys may lead to gross underestimation of disability related to psychiatric morbidity.

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Military and demographic predictors of mental ill-health and socioeconomic hardship among UK veterans

BMC Psychiatry ◽

10.1186/s12888-021-03296-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

H. Burdett ◽

N. T. Fear ◽

S. Wessely ◽

R. J. Rona

Keyword(s):

Socioeconomic Status ◽

Common Mental Disorders ◽

Economic Status ◽

Childhood Adversity ◽

Armed Forces ◽

Sociodemographic Factors ◽

Post Traumatic Stress ◽

Length Of Service ◽

Socioeconomic Outcomes ◽

The Uk

Abstract Background Around 8% of the UK Armed Forces leave in any given year, and must navigate unfamiliar civilian systems to acquire employment, healthcare, and other necessities. This paper determines longer-term prevalences of mental ill health and socioeconomic outcomes in UK Service leavers, and how they are related to demographic factors, military history, and pre-enlistment adversity. Methods This study utilised data from a longitudinal sample of a cohort study UK Armed Forces personnel since 2003. A range of self-reported military and sociodemographic factors were analysed as predictors of probable Post-Traumatic Stress Disorder, common mental disorders, alcohol misuse, unemployment and financial hardship. Prevalences and odds ratios of associations between predictors and outcomes were estimated for regular veterans in this cohort. Results Veteran hardship was mostly associated with factors linked to socio-economic status: age, education, and childhood adversity. Few military-specific factors predicted mental health or socio-economic hardship, except method of leaving (where those leaving due to medical or unplanned discharge were more likely to encounter most forms of hardship as veterans), and rank which is itself related to socioeconomic status. Conclusion Transition and resettlement provisions become increasingly generous with longer service, yet this paper shows the need for those services becomes progressively less necessary as personnel acquire seniority and skills, and instead could be best targeted at unplanned leavers, taking socioeconomic status into consideration. Many will agree that longer service should be more rewarded, but the opposite is true if provision instead reflects need rather than length of service. This is a social, political and ethical dilemma.

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Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014

BJPsych Open ◽

10.1192/bjpo.bp.115.002246 ◽

2016 ◽

Vol 2 (1) ◽

pp. 18-24 ◽

Cited By ~ 25

Author(s):

Sebastião Viola ◽

Joanna Moncrieff

Keyword(s):

Anxiety Disorder ◽

Mental Disorders ◽

Mental Disorder ◽

Common Mental Disorders ◽

Disability Benefits ◽

Common Cause ◽

Individual Support ◽

Government Data ◽

The Uk

BackgroundThere is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims.AimsTo examine trends in sickness and disability benefits awarded for mental disorders in the UK.MethodThe researchers analysed UK Government data from 1995 to 2014.ResultsMental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder.ConclusionsCommon mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.

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Food insecurity and common mental disorders in perinatal women living in low socio-economic settings in Cape Town, South Africa during the COVID-19 pandemic: a cohort study

10.21203/rs.3.rs-692244/v2 ◽

2021 ◽

Author(s):

Zulfa Abrahams ◽

Crick Lund

Keyword(s):

Mental Health ◽

South Africa ◽

Mental Disorders ◽

Food Insecurity ◽

Common Mental Disorders ◽

Cape Town ◽

Baseline Risk ◽

Multivariable Logistic Regression Analysis ◽

Perinatal Women

Abstract Background Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with poverty, food insecurity and domestic violence. We used data collected from perinatal women at two time-points during the COVID-19 pandemic to test the hypotheses that (1) socio-economic adversities at baseline would be associated with higher CMD prevalence at follow-up and (2) worse mental health at baseline would be associated with higher food insecurity prevalence at follow-up. Methods Telephonic interviews were conducted with perinatal women attending healthcare facilities in Cape Town, South Africa. Multivariable logistic regression analysis was used to model the associations of baseline risk factors with the prevalence of household food insecurity and CMD at 3 months follow-up. Results At baseline 859 women were recruited, of whom 217 (25%) were pregnant, 106 (12%) had probable CMD, and 375 (44%) were severely food insecure. At follow-up (n=634), 22 (4%) were still pregnant, 44 (7%) had probable CMD, and 207 (33%) were severely food insecure. In the multivariable regression model, after controlling for confounders, the odds of being food insecure at follow-up were greater in women who were unemployed [OR=2.05 (1.46-2.87); p<0.001] or had probable CMD [OR=2.37 (1.35-4.18); p=0.003] at baseline; and the odds of probable CMD at follow-up were greater in women with psychological distress [OR=2.81 (1.47-5.39); p=0.002] and abuse [OR=2.47 (1.47-4.39); p=0.007] at baseline. Conclusions This study highlights the complex bidirectional relationship between mental health and socioeconomic adversity among perinatal women during the COVID-19 pandemic.

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Childhood Socioeconomic Status and Later Life Cognition: Evidence From the Wisconsin Longitudinal Study

Journal of Aging and Health ◽

10.1177/0898264318783489 ◽

2018 ◽

Vol 31 (9) ◽

pp. 1589-1615 ◽

Cited By ~ 8

Author(s):

Emily A. Greenfield ◽

Sara M. Moorman

Keyword(s):

Socioeconomic Status ◽

Executive Function ◽

Longitudinal Study ◽

Household Income ◽

Statistical Significance ◽

Occupational Status ◽

Later Life ◽

Socioeconomic Differences ◽

Wisconsin Longitudinal Study ◽

Childhood Socioeconomic Status

Objectives:This study examined childhood socioeconomic status (SES) as a predictor of later life cognition and the extent to which midlife SES accounts for associations. Methods: Data came from 5,074 participants in the Wisconsin Longitudinal Study. Measures from adolescence included parents’ educational attainment, father’s occupational status, and household income. Memory and language/executive function were assessed at ages 65 and 72 years. Results: Global childhood SES was a stronger predictor of baseline levels of language/executive function than baseline memory. Associations involving parents’ education were reduced in size and by statistical significance when accounting for participants’ midlife SES, whereas associations involving parental income and occupational status became statistically nonsignificant. We found no associations between childhood SES and change in cognition. Discussion: Findings contribute to growing evidence that socioeconomic differences in childhood have potential consequences for later life cognition, particularly in terms of the disparate levels of cognition with which people enter later life.

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Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106353 ◽

2020 ◽

Vol 77 (7) ◽

pp. 454-461 ◽

Cited By ~ 1

Author(s):

Marijke Keus van de Poll ◽

Lotta Nybergh ◽

Caroline Lornudd ◽

Jan Hagberg ◽

Lennart Bodin ◽

...

Keyword(s):

Mental Health ◽

Problem Solving ◽

Mental Disorders ◽

Occupational Health ◽

Sickness Absence ◽

Primary Outcome ◽

Common Mental Disorders ◽

Significant Group ◽

Secondary Outcomes

ObjectivesCommon mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.MethodsRandomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.ResultsA statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.ConclusionPSI was effective in reducing sickness absence which was the primary outcome in this study.

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