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Cited by 107Suicide and Self-Harm StudiesHealth disparities and outcomesMental Health Treatment and Access

The Association Between Income and Distress, Mental Disorders, and Suicidal Ideation and Attempts: Findings From the Collaborative Psychiatric Epidemiology Surveys

McMillan, Katherine A., Enns, Murray W., Asmundson, Gordon J. G., Sareen, Jitender·2010·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.08m04986gry
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Abstract

OBJECTIVE: To examine the relationship between household income and psychological distress, suicidal ideation and attempts, and mood, anxiety, and substance use disorders. METHOD: Data came from the Collaborative Psychiatric Epidemiology Surveys, a collection of 3 nationally representative surveys of American adults conducted between 2001 and 2003. Psychological distress, suicidal ideation, suicide attempts, and mood, anxiety, and substance use disorders were examined in relation to household income after adjusting for sex, marital status, race, age, and employment status. RESULTS: Analyses revealed an inverse association between income and psychological distress as measured by the Kessler Psychological Distress Scale, with those in the lowest income quartile demonstrating significantly more distress than any of the remaining 3 income quartiles (P < .05). Subsequent analysis of DSM-IV-diagnosed psychological disorders revealed a similar pattern of results, which were particularly strong for substance use disorders (adjusted odds ratio [AOR] = 1.74; 95% CI, 1.39-2.18), suicidal ideation (AOR = 1.77; 95% CI, 1.46-2.13), and suicide attempts (AOR = 2.15; 95% CI, 1.55-2.98). The association between income and mood and anxiety disorders was less consistent, and the relationship between income and suicidal ideation differed among the 5 race categories (non-Hispanic white, Hispanic, Asian American, black, and other). Non-Hispanic white persons showed a strong, negative relationship between income and suicidal ideation (AOR = 2.15; 95% CI, 1.66-2.80), while the association was considerably weaker or nonexistent for the other races. CONCLUSIONS: Although conclusions cannot be drawn concerning causation, the strength of associations between income, suicidal ideation, suicide attempts, and substance abuse points to the need for secondary prevention strategies among low-income, high-risk populations.

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  • Personal earnings and household income of people with major depressive disorder are substantially lower than those without depression, but it is unclear whether depression is primarily a cause, consequence, or both because of reciprocal causation; previous studies have not controlled for reciprocal effects, making the size of adverse effects uncertain; childhood-adolescence depression predicts

    “One of most striking aspects of the impairment associated with MDD is that the personal earnings and household income of people with MDD are substantially lower than those of people without depression.68–73 However, it is unclear whether depression is primariry a cause, consequence, or both in these associations due to the possibility of reciprocal causation between income-earnings and MDD.74”

    From The Costs of Depression (2012) · cites this paper as [72]

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Authors
McMillan, K. A., Enns, M. W., Asmundson, G. J. G., & Sareen, J.
Affiliations
University of Regina (CA)
Corresponding author
McMillan, Katherine A.
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2010-04-06
Volume
71
Issue
09
Pages
1168-1175
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.08m04986gry
OpenAlex
W2087277252
Cited by
107
References
0
Citations by year
2026: 6 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 15 · 2021: 4 · 2020: 3 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 3 · 2014: 12 · 2013: 4 · 2012: 4
FWCI
5.98
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
Canadian Institutes of Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
household income, psychological distress, suicidal ideation, suicide attempts, mood disorders, anxiety disorders, substance use disorders, socioeconomic status, racial differences, low-income populations, secondary prevention
MeSH terms
Adolescent, Adult, Aged, Anxiety Disorders, Asian, Mental Disorders, Black or African American, Depressive Disorder, Employment, Female, Health Surveys, Hispanic or Latino, Humans, Income, Male, Middle Aged, Risk Factors, Suicide, Attempted, United States, Substance-Related Disorders, Black People, White People, Young Adult

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