Social position at different points of the life-course and depressive symptoms of men and women in the Czech Republic

Česká verzia

Authors: A. Nicholson ¹; H. Pikhart ^1,2; R. Kubínová ³; A. Peasey ¹; N. Čapková ³; M. Marmot ¹; M. Bobák ¹
Authors place of work: International Institute for Health and Society, Department of Epidemiology and Public Health University College London, UK Vedoucí: prof. Sir Michael Marmot ¹; Univerzita Karlova v Praze, 1. LF a VFN, Ústav hygieny a epidemiologie Přednosta: prof. MUDr. Vladimír Bencko, DrSc. ²; Centrum hygieny životního prostředí, Státní zdravotní ústav, Praha Vedoucí: MUDr. Růžena Kubínová ³
Published in the journal: Prakt. Lék. 2008; 88(5): 276-281
Category: Of different specialties

Summary

Objectives:
Research into social inequalities in depression has studied western populations but data from non-western countries are sparse. In this paper, we investigate the extent of social inequalities in depression in the Czech Republic, the relative importance of social position at different points of the life-course, and whether social patterning of depression differs between men and women.

Methods:
A cross-sectional study examined 3 835 men and 4 398 women in the Czech Republic. Depressive symptoms (16 or above on the CESD-20) were examined in relation to socio-economic circumstances at three phases of the life-course: childhood household amenities; own education; current circumstances (financial difficulties and possession of household items)

Results:
Pronounced social differences in depression were found in men and women. Depression was influenced by current circumstances with a persisting effect from childhood disadvantage but weaker influence of education. Odds ratios for current disadvantage were 2.17 [1.80–2.63] and 1.92 [1.67–2.22] in men and women respectively and for childhood disadvantage were 1.36 [1.06–1.74] and 1.73 [1.43–2.10]. There was a female excess in depression, (sex differential of 1.95 [1.74–2.18]) which was not explained by any social variables.

Limitations:
Cross-sectional data with recall of childhood conditions were used.

Conclusions:
Current social circumstances are the strongest influence on increased depressive symptoms in the Czech Republic but there is persistent effect of childhood disadvantage.

Key words:
social inequalities, depression, social factors, socio-economic inequalities, phases of the live-course, childhood disadvantage.

Zdroje

1. Araya, R., Lewis,G., Rojas,G. et al. Education and income: which is more important for mental health? J. Epidemiol. Community Health 2003; 57(7), p. 501-505.

2. Bebbington, P., Dunn, R., Jenkins, R. et al. The influence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity. International Review of Psychiatry 2007, 15, p. 74-83.

3. Beekman, A.T.F., Deeg, D.J.H., Van Limbeek, J. et al. Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D) : results from a community-based sample of older subjects in the Netherlands. Psychol. Med. 1997, 27, p. 231-235.

4. Berney, L.R., Blane, D. Collecting retrospective data: accuracy of recall after 50 years judged against historical records. Soc. Sci. Med. 1997, 45, p. 1519-1525.

5. Boys, A., Farrell, M., Taylor, C. et al. Psychiatric morbidity and substance use in young people aged 13-15 years: results from the Child and Adolescent Survey of Mental Health. Br. J. Psychiatry 2003,182, p. 509-517.

6. Brown, G.W., Harris, T. Social origins of depression. London: Tavistock Publications; 1978.

7. Ferketich, A.K., Schwartzbaum, J.A., Frid, D.J. et al. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Arch. Int. Med. 2000,160(9), p. 1261-1268.

8. Fountoulakis, K., Iacovides, A., Kleanthous, S. et al. Reliability, validity and psychometric properties of the Greek translation of the Center for Epidemiological Studies-Depression (CES-D) Scale. BMC Psychiatry 2001, 1, p. 3.

9. Gallo, L.C., Matthews, K.A. Do negative emotions mediate the association between scoioeconomic status and health? Ann. NY Acad. Sci. 1999, 896, p. 226-245.

10. Gelder, M., Gath, D., Mayou, R. Oxford Textbook of Psychiatry. Oxford: Oxford University Press; 1985.

11. Gilman, S.E., Kawachi, I., Fitzmaurice, G.M. et al. Socioeconomic status in childhood and the lifetime risk of major depression. Int. J. Epidemiol. 2002, 31, p. 359-367.

12. Hallqvist, J., Lynch, J., Bartley, M. et al. Can we disentangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Epidemiology Program. Social Science and Medicine 2004, 58(8), p. 1555-1562.

13. Kessler, R.C., Davis, C.G., Kendler, K.S. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol. Med. 1997; 27(5), p. 1101-1119.

14. Kessler, R.C., McGonagle, K.A., Zhao, S. et al. Lifetime and 12-month prevalence of DSM-lII-R psychiatric disorders in the United States. Arch. Gen. Psychiatry 1994, 51, p. 8-19.

15. Kim, E., Jo, S.A., Hwang, J.Y. et al. A survey of depressive symptoms among South Korean adults after the Korean financial crisis of late 1997: prevalence and correlates. Ann. Epidemiol. 2005,15(2), p. 145-152.

16. Kuehner, C. Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. A cta Psychiatrica Scandinavica 2003; 108, p. 163-174.

17. Kuh, D., Head, J., Hardy, R. et al. The influence of education and family background on women’s earnings in midlife: evidence from a British national cohort study. Br. J. Sociol. Educ. 1997, 18, p. 385-405.

18. Kuh, D., Wadsworth, M. Childhood influences on adult male earnings in a longitudinal study. Br. J. Sociology 1991, 42, p. 537-555.

19. Lewis, G., Bebbington, P., Brugha, T. et al. Socioeconomic status, standard of living, and neurotic disorder. Lancet 1998; 352(9128), p. 605-609.

20. Lorant, V., Deliege, D., Eaton, W. et al. Socioeconomic inequalities in depression: A meta-analysis. Am. J. Epidemiology 2003, 157, p. 98-112.

21. Lundberg, O. The impact of childhood living conditions on illness and mortality in adulthood. Soc. Sci. Med. 1993, 36(8), p. 1047-1052.

22. Lyness, J.M., Noel, T.K., Cox, C. et al. Screening for depression in elderly primary care patients. Arch. Intern. Med. 1997, 157, p. 449-454.

23. Marmot, M., Bobak, M. Social and economic changes and health in Europe East and West. European Review 2005, 13, p. 15-31.

24. Miech, R.A., Eaton, W.W., Brennan, K. Mental health disparities across education and sex: a prospective analysis examining how they persist over the life course. J. Gerontol. B. Psychol. Sci. Soc. Sci. 2005, 60 Spec. 2, 93-98.

25. Murray, C.J.L., Lopez, A.D. Alternative projections of mortality and disability by cause 1990-2020: global burden of disease study. Lancet 1997, 349, p. 1498-1504.

26. Naess, O., Hernes, F.H., Blane, D. Life-course influences on mortality at older ages: evidence from the Oslo Mortality Study. Soc. Sci. Med. 2006, 62(2), p. 329-336.

27. Nicholson, A., Bobak, M., Murphy, M. et al. Socio-economic influences on self-rated health in Russian men and women-a life course approach. Soc. Sci. Med. 2005, 61(11), p. 2345-2354.

28. Nicholson, A., Pikhart, H., Pajak, A. et al. Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe. J. Affect. Disord. 2008,105(1-3), p. 125-136.

29. Osecka, L. Skala deprese CES-D - psychometricka analyza. Brno: Czech Academy of Sciences; 1999.

30. Peasey, A., Bobak, M., Kubinova, R. et al. Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: rationale and design of the HAPIEE study. BMC Public Health 2006, 6. p. 255.

31. Penninx, B.W., Geerlings, S.W., Deeg, D.J. et al. Minor and major depression and the risk of death in older persons. Arch. Gen. Psychiatry 1999, 56(10), p. 889-895.

32. Power, C., Hertzman, C., Matthews, S. et al. Social differences in health: life-cycle effects between ages 23 and 33 in the 1958 British birth cohort. Am. J. Pub. Health 1997, 87, p. 1499-1503.

33. Radloff, L.S. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1977, 1, p. 385-401.

34. Roberts, R.E., Vernon, S.W. The Center for Epidemiologic Studies Depression scale: its use in a community sample. Am. J. Psychiatry 1983, 140, p. 41-46.

35. Ross, C.E., Mirowsky, J. Sex differences in the effect of education on depression: resource multiplication or resource substitution? Soc. Sci. Med. 2006, 63(5), p. 1400-1413.

36. Watson, D, Clark, LA. Negative affectivity; the disposition to experience aversive emotional states. Psychological Bulletin 1984, 96, p. 465-490.

37. Weich, S., Blanchard, M., Prince, M. et al. Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. Br. J. Psychiatry 2002; 180, p. 428-433.

38. Weissman, M.M., Bland, R.C., Canino, G.J. et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996, 276(4), p. 293-299.

39. Zunzunegui, M.V., Beland, F., Otero, A. Support from children, living arrangements, self-rated health and depressive symptoms of older people in Spain. Int. J. Epidemiol. 2001, 30(5), p. 1090-1099.