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The Association Between Income and Distress, Mental Disorders, and Suicidal Ideation and Attempts: Findings From the Collaborative Psychiatric Epidemiology Surveys
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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“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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Metadata
- Authors
- McMillan, K. A., Enns, M. W., Asmundson, G. J. G., & Sareen, J.
- Affiliations
- University of Regina (CA)
- Corresponding author
- McMillan, Katherine A.
- 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)
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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