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Cited by 146Health disparities and outcomesMental Health Treatment and AccessEmployment and Welfare Studies

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Associations Between Subjective Social Status and DSM-IV Mental Disorders: Results From the World Mental Health Surveys

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Scott, Kate M., Al-Hamzawi, Ali Obaid, Andrade, Laura H., Borges, Guilherme, Caldas-de-Almeida, Jose Miguel, Fiestas, Fabian, Gureje, Oye, Hu, Chiyi, Karam, Elie G., Kawakami, Norito, Lee, Sing, Levinson, Daphna, Lim, Carmen C. W., Navarro-Mateu, Fernando, Okoliyski, Michail, Posada-Villa, Jose, Torres, Yolanda, Williams, David R., Zakhozha, Victoria, Kessler, Ronald C.·2014·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2014.1337PMC PMC5315238
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Abstract

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.

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  1. [18]McLeod JD Social stratification and inequality Handbook of the Sociology of Mental Health 2013 Springer 229 253

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Metadata

Authors
Scott, K. M., Al-Hamzawi, A. O., Andrade, L. H., Borges, G., Caldas-de-Almeida, J. M., Fiestas, F., Gureje, O., Hu, C., Karam, E. G., Kawakami, N., Lee, S., Levinson, D., Lim, C. C. W., Navarro-Mateu, F., Okoliyski, M., Posada-Villa, J., Torres, Y., Williams, D. R., Zakhozha, V., & Kessler, R. C.
Affiliations
  • University of Otago (NZ)
  • University of Al-Qadisiyah (IQ)
  • Universidade de São Paulo (BR)
  • Universidad Autónoma Metropolitana (MX)
  • Chronic Diseases Research Center and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
  • National Institute of Health of Peru, Evidence Generation Research Unit, Lima, Peru
  • University of Ibadan (NG)
  • Shenzhen KangNing Hospital (CN)
  • University of Balamand (LB)
  • The University of Tokyo (JP)
  • Chinese University of Hong Kong (HK)
  • Israel Ministry of Health (IL)
  • Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar, Murcia, Spain
  • National Center of Public Health and Analyses (BG)
  • Colegio Mayor de Cundinamarca University, Bogota, DC, Colombia
  • Universidad CES (CO)
  • Harvard University (US)
  • Kyiv International Institute of Sociology (Ukraine) (UA)
Corresponding author
Scott, Kate M.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2014-12-01
Volume
71
Issue
12
Pages
1400
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2014.1337
PMC
PMC5315238
OpenAlex
W2010224574
Cited by
146
References
30
Citations by year
2026: 6 · 2025: 20 · 2024: 18 · 2023: 8 · 2022: 17 · 2021: 12 · 2020: 15 · 2019: 14 · 2018: 8 · 2017: 12 · 2016: 10 · 2015: 5 · 2014: 1
FWCI
11.92
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Robert Wood Johnson Foundation (044708)
  • John W. Alden Trust
  • Pfizer
  • GlaxoSmithKline
  • University of Michigan
  • Public Health Agency
  • Bundesministerium für Gesundheit
  • Universidade de Lisboa
  • Fundación para la Formación e Investigación Sanitarias de la Región de Murcia
  • Servicio Murciano de Salud
  • Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu
  • Servier
  • H. Lundbeck A/S
  • Fundação Champalimaud
  • Ministerio de Salud
  • Ministerstwo Zdrowia
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration
  • Pfizer Foundation
  • Health Research Council of New Zealand
  • Consejería de Sanidad y Política Social, Comunidad Autónoma de la Región de Murcia
  • National Institute of Mental Health (R13-MH-066849, R0 1-MH61905, R01‐MH070884, U01-MH-60220, R01MH061905, R01MH059575, MH60220, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (R03TW006481)
  • Cilag
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
Keywords
subjective social status, mental illness, objective social status, mood disorders, anxiety disorders, impulse control disorders, social selection, social causation, income, educational attainment, occupation, cross-national comparison, low- and middle-income countries, DSM-IV, Composite International Diagnostic Interview, prevalence of mental disorders, social determinants of mental health
MeSH terms
Adolescent, Adult, Aged, Anxiety Disorders, Female, Health Surveys, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Middle Aged, Social Class, Prevalence, Mood Disorders, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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