Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

Open Access 01-07-2018 | Original Paper

Social inequalities in mental disorders and substance misuse in young adults

A birth cohort study in Southern Brazil

Authors: Fernando C. Barros, Alicia Matijasevich, Iná S. Santos, Bernardo L. Horta, Bruna Gonçalves C. da Silva, Tiago N. Munhoz, Seena Fazel, Alan Stein, Rebecca M. Pearson, Luciana Anselmi, Luis Augusto Rohde

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2018

Abstract

Purpose

To investigate the association between mental disorders and substance misuse at 30 years of age with gender, socioeconomic position at birth, and family income trajectories.

Methods

The 1982 Pelotas Birth Cohort was used; all 5914 children born alive at hospital were originally enrolled (99.2% of all city births). In 2012, 3701 subjects were located and interviewed (68% retention rate). Mental disorders and substance misuse were assessed, and their prevalence analysed according to gender, socioeconomic status at birth, and four different income trajectories: always poor, never poor, poor at birth/non-poor at age 30, and non-poor at birth/poor at age 30.

Results

While women presented higher prevalence of mental disorders, substance misuse was much more frequent among men. Individuals in the lowest income quintile at birth presented 2–5 times more mental disorders and substance misuse than those in the highest quintile. Young adults who were always poor or were not poor at birth but were poor at 30 years of age had a higher prevalence of mental disorders than the other groups.

Conclusions

The high rates of mental disorders and lifetime suicide attempts in young adults, especially those who were always poor or became poor after childhood, suggest that recent socioeconomic-related stressful situations may have a higher impact on the current mental health than events earlier in life. However, we could not identify at what specific ages socioeconomic changes were more important.

Available only for authorised users

Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, Ustun TB, Wang PS (2009) The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc 18(1):23–33CrossRefPubMedPubMedCentral

Vigo D, Thornicroft G, Atun R (2016) Estimating the true global burden of mental illness. Lancet Psychiatry 3(2):171–178. https://doi.org/10.1016/S2215-0366(15)00505-2 CrossRefPubMed

World Health Organization and Calouste Gulbenkian Foundation (2014) Social determinants of mental health. World Health Organization, Geneva

Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, Swartz L, Patel V (2010) Poverty and common mental disorders in low and middle income countries: A systematic review. Soc Sci Med 71(3):517–528. https://doi.org/10.1016/j.socscimed.2010.04.027 CrossRefPubMedPubMedCentral

Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A (2011) Child and adolescent mental health worldwide: evidence for action. Lancet 378(9801):1515–1525. https://doi.org/10.1016/S0140-6736(11)60827-1 CrossRefPubMed

Maselko J (2017) Social epidemiology and global mental health: expanding the evidence from high-income to low- and middle-income Countries. Curr Epidemiol Rep 4(2):166–173. https://doi.org/10.1007/s40471-017-0107-y CrossRefPubMedPubMedCentral

Burns JK (2015) Poverty, inequality and a political economy of mental health. Epidemiol Psychiatr Sci 24(2):107–113. https://doi.org/10.1017/S2045796015000086 CrossRefPubMed

Daniel JZ, Hickman M, Macleod J, Wiles N, Lingford-Hughes A, Farrell M, Araya R, Skapinakis P, Haynes J, Lewis G (2009) Is socioeconomic status in early life associated with drug use? a systematic review of the evidence. Drug alcohol review 28(2):142–153. https://doi.org/10.1111/j.1465-3362.2008.00042.x CrossRefPubMed

Bjorkenstam E, Cheng S, Burstrom B, Pebley AR, Bjorkenstam C, Kosidou K (2017) Association between income trajectories in childhood and psychiatric disorder: a Swedish population-based study. J Epidemiol Community Health. https://doi.org/10.1136/jech-2016-208513 PubMedCrossRef

10.

Costello EJ, Compton SN, Keeler G, Angold A (2003) Relationships between poverty and psychopathology: a natural experiment. JAMA 290(15):2023–2029. https://doi.org/10.1001/jama.290.15.2023 CrossRefPubMed

11.

Victora CG, Barros FC (2006) Cohort profile: the 1982 Pelotas (Brazil) birth cohort study. Int J Epidemiol 35(2):237–242. https://doi.org/10.1093/ije/dyi290 CrossRefPubMed

12.

Horta BL, Gigante DP, Goncalves H, dos Santos Motta J, Loret de Mola C, Oliveira IO, Barros FC, Victora CG (2015) Cohort profile update: the 1982 Pelotas (Brazil) Birth Cohort Study. Int J Epidemiol 44(2):441, 441a–441e. https://doi.org/10.1093/ije/dyv017.CrossRefPubMed

13.

Nagin D, Tremblay RE (1999) Trajectories of boys’ physical aggression, opposition, and hyperactivity on the path to physically violent and nonviolent juvenile delinquency. Child Dev 70(5):1181–1196CrossRefPubMed

14.

Nagin DS (2005) Group-based modeling of development. Harvard University Press, CambridgeCrossRef

15.

Nagin DS, Odgers CL (2010) Group-based trajectory modeling in clinical research. Ann Rev Clin Psychol 6:109–138. https://doi.org/10.1146/annurev.clinpsy.121208.131413 CrossRef

16.

Jones BL, Nagin DS (2013) A note on a Stata plugin for estimating group-based trajectory models. Sociol Methods Res 42(4):608–613. https://doi.org/10.1177/0049124113503141 CrossRef

17.

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 20(59 Suppl):22–33 (quiz 34–57)

18.

Amorim P (2000) Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Brasil Psiquiatr 22:106–115CrossRef

19.

de Azevedo Marques JM, Zuardi AW (2008) Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil. Gen Hosp Psychiatry 30(4):303–310. https://doi.org/10.1016/j.genhosppsych.2008.02.001 CrossRefPubMed

20.

Barbor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG (2001) AUDIT. The alcohol use disorders identification test. Guidelines for use in primary care. World Health Organization. Department of Mental Health and Substance Dependence, Geneva

21.

Mendez EB (1999) A Brazilian version of AUDIT (alcohol use identification test). Federal University of Pelotas, Pelotas, Brazil

22.

Harding TW, de Arango MV, Baltazar J, Climent CE, Ibrahim HH, Ladrido-Ignacio L, Murthy RS, Wig NN (1980) Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychol Med 10(2):231–241CrossRefPubMed

23.

Mari JJ, Williams P (1986) A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. Br J Psychiatry 148:23–26CrossRefPubMed

24.

Daniel RM, Cousens SN, De Stavola BL, Kenward MG, Sterne JA (2013) Methods for dealing with time-dependent confounding. Stat Med 32(9):1584–1618. https://doi.org/10.1002/sim.5686 CrossRefPubMed

25.

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602. https://doi.org/10.1001/archpsyc.62.6.593 CrossRefPubMed

26.

Moffitt TE, Harrington H, Caspi A, Kim-Cohen J, Goldberg D, Gregory AM, Poulton R (2007) Depression and generalized anxiety disorder: cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Arch Gen Psychiatry 64(6):651–660. https://doi.org/10.1001/archpsyc.64.6.651 CrossRefPubMed

27.

Boyd A, Van de Velde S, Vilagut G, de Graaf R, O’Neill S, Florescu S, Alonso J, Kovess-Masfety V (2015) Gender differences in mental disorders and suicidality in Europe: results from a large cross-sectional population-based study. J Affect Disord 173:245–254. https://doi.org/10.1016/j.jad.2014.11.002 CrossRefPubMed

28.

Hossain MD, Ahmed HU, Chowdhury WA, Niessen LW, Alam DS (2014) Mental disorders in Bangladesh: a systematic review. BMC psychiatry 14:216. https://doi.org/10.1186/s12888-014-0216-9 CrossRefPubMedPubMedCentral

29.

Dias Da Costa J, Giraldi MC, Carret MLV, Ferreira AMT, Strauch ES, Moraes M (2013) Evolução da mortalidade por causas externas no municipio de Pelotas e no estado do Rio Grande do Sul, Brasil, 1996–2009. Epidemiol Serv Saúde 22(2):215–224CrossRef

30.

Hu J, Dong Y, Chen X, Liu Y, Ma D, Liu X, Zheng R, Mao X, Chen T, He W (2015) Prevalence of suicide attempts among Chinese adolescents: a meta-analysis of cross-sectional studies. Compr psychiatry 61:78–89. https://doi.org/10.1016/j.comppsych.2015.05.001 CrossRefPubMed

31.

Cao XL, Zhong BL, Xiang YT, Ungvari GS, Lai KY, Chiu HF, Caine ED (2015) Prevalence of suicidal ideation and suicide attempts in the general population of China: a meta-analysis. Int J Psychiatry Med 49(4):296–308. https://doi.org/10.1177/0091217415589306 CrossRefPubMedPubMedCentral

32.

Aggarwal S, Patton G, Reavley N, Sreenivasan SA, Berk M (2017) Youth self-harm in low- and middle-income countries: systematic review of the risk and protective factors. Int J Soc Psychiatry:20764017700175. https://doi.org/10.1177/0020764017700175

33.

World Health Organization (2015) Mental health atlas 2014. World Health Organization, Geneva

34.

Sanchez ZM, Locatelli DP, Noto AR, Martins SS (2013) Binge drinking among Brazilian students: a gradient of association with socioeconomic status in five geo-economic regions. Drug Alcohol Depend 127(1–3):87–93. https://doi.org/10.1016/j.drugalcdep.2012.06.018 CrossRefPubMed

35.

Guilamo-Ramos V, Jaccard J, Turrisi R, Johansson M (2005) Parental and school correlates of binge drinking among middle school students. Am J Public Health 95(5):894–899. https://doi.org/10.2105/AJPH.2003.018952 CrossRefPubMedPubMedCentral

36.

Baumann M, Spitz E, Guillemin F, Ravaud JF, Choquet M, Falissard B, Chau N, Lorhandicap g (2007) Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study. Int J Health Geogr 6:50. https://doi.org/10.1186/1476-072X-6-50 CrossRefPubMedPubMedCentral

37.

Malta DC, Stopa SR, Iser BP, Bernal RT, Claro RM, Nardi AC, Dos Reis AA, Monteiro CA (2015) Risk and protective factors for chronic diseases by telephone survey in capitals of Brazil, Vigitel 2014. Rev Bras Epidemiol 18(Suppl 2):238–255. https://doi.org/10.1590/1980-5497201500060021 CrossRefPubMed

38.

Borges G, Bagge CL, Cherpitel CJ, Conner KR, Orozco R, Rossow I (2017) A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychol Med 47(5):949–957. https://doi.org/10.1017/s0033291716002841 CrossRefPubMed

39.

Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31. https://doi.org/10.1016/j.socscimed.2013.04.026 CrossRefPubMed

40.

Anselmi L, Menezes AM, Hallal PC, Wehrmeister F, Goncalves H, Barros FC, Murray J, Rohde LA (2012) Socioeconomic changes and adolescent psychopathology in a Brazilian birth cohort study. J Adolesc Health 51(6 Suppl):S5-10. https://doi.org/10.1016/j.jadohealth.2012.06.026 PubMedCrossRef

41.

Barbaglia MG, ten Have M, Dorsselaer S, Alonso J, de Graaf R (2015) Negative socioeconomic changes and mental disorders: a longitudinal study. J Epidemiol Community Health 69(1):55–62. https://doi.org/10.1136/jech-2014-204184 CrossRefPubMed

42.

Rutter M (1982) Prevention of children’s psychosocial disorders: myth and substance. Pediatrics 70(6):883–894PubMed

43.

Paim J, Travassos C, Almeida C, Bahia L, Macinko J The Brazilian health system: history, advances, and challenges. Lancet 377 (9779):1778–1797. https://doi.org/10.1016/S0140-6736(11)60054-8

44.

Nelson JP (2015) Binge drinking and alcohol prices: a systematic review of age-related results from econometric studies, natural experiments and field studies. Health Econ Rev 5:6. https://doi.org/10.1186/s13561-014-0040-4 CrossRefPubMedPubMedCentral

45.

Home Office (2011) The likely impacts of increasing alcohol prices: a summary review of the evidence based. Home Office, United Kingdom

Title: Social inequalities in mental disorders and substance misuse in young adults
A birth cohort study in Southern Brazil
Authors: Fernando C. Barros
Alicia Matijasevich
Iná S. Santos
Bernardo L. Horta
Bruna Gonçalves C. da Silva
Tiago N. Munhoz
Seena Fazel
Alan Stein
Rebecca M. Pearson
Luciana Anselmi
Luis Augusto Rohde
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 7/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-018-1526-x

At a glance: The STEP trials

Springer Medicine

Social inequalities in mental disorders and substance misuse in young adults

A birth cohort study in Southern Brazil

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2018

Baby or bathwater? Referrals of “non-cases” in a targeted early identification intervention for psychosis

Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016

Prevalence and risk factors of psychiatric disorders in early adolescence: 2004 Pelotas (Brazil) birth cohort

Behavioral problem trajectories and self-esteem changes in relation with adolescent depressive symptoms: a longitudinal study

Inhalant use in adolescents in northern Russia

Distress and burnout in young medical researchers before and during the Greek austerity measures: forerunner of a greater crisis?