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BMC Psychiatry
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Social differences in diagnosed depression among adolescents in a Swedish population based cohort

Authors: Therese Wirback, Jette Möller, Jan-Olov Larsson, Karin Engström

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

Population based research regarding social differences in diagnosed depression in adolescence is sparse. In this study unique material containing in-and outpatient data was used to determine if low social position in childhood increases the risk of diagnosed depression in adolescence. To further examine this association, gender differences and interactions were explored.

Methods

The study population was extracted from the Stockholm Youth Cohort (SYC), a register based cohort containing psychiatric care for all young people in Stockholm County and information about social position. For the purpose of this study, all in the SYC who turned 13 years old during 2001–2007, in total 169,262 adolescents, were followed up in 2005–2011 for diagnoses of depression until age 18. Associations were estimated with Cox regression models and presented as Hazard Ratios (HR).

Results

The risk of diagnosed depression was higher for adolescents with parents with low education (HR = 1.1, CI = 1.0–1.2) and medium education (HR = 1.1, CI = 1.1–1.2) compared to high as well as for those with lower household income (for example, medium low, HR = 1.2, CI = 1.1–1.3) and for those with parents who received an unemployment benefit (HR = 1.3, CI = 1.2–1.4). No differences were found for those with the lowest household income compared to those with the highest level. Adolescents with parents born outside the Nordic countries had a lower risk of diagnosed depression (HR = 0.7, CI = 0.6–0.7). An interaction effect was found between gender and parental education.

Conclusions

Social differences were found but the magnitude was modest and gender differences small.
Literature
1.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2163–96.CrossRefPubMed
2.
Gore FM, Bloem PJN, Patton GC. Global burden of disease in young people aged 10-24 years: a systematic analysis. Lancet. 2011;378(9790):486.
3.
Fryers T, Brugha T. Childhood determinants of adult psychiatric disorder. Clin Pract Epidemiol : CP & EMH. 2013;9:1–50.CrossRef
4.
Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL. Socioeconomic status in childhood and the lifetime risk of major depression. Int J Epidemiol. 2002;31(2):359–67.CrossRefPubMed
5.
National Board of Health and Welfare. Public Health Report 2009. Stockholm: National Board of Health and Welfare; 2009.
6.
Amone-P’Olak K, Burger H, Ormel J, Huisman M, Verhulst FC, Oldehinkel AJ. Socioeconomic position and mental health problems in pre- and early-adolescents: the TRAILS study. Soc Psychiatry Psychiatr Epidemiol. 2009;44(3):231–8.CrossRefPubMed
7.
Lemstra M, Neudorf C, D'Arcy C, Kunst A, Warren LM, Bennett NR. A systematic review of depressed mood and anxiety by SES in youth aged 10-15 years. Can J Public Health Revue canadienne de sante publique. 2008;99(2):125–9.PubMed
8.
Rajmil L, Herdman M, Ravens-Sieberer U, Erhart M, Alonso J. Socioeconomic inequalities in mental health and health-related quality of life (HRQOL) in children and adolescents from 11 European countries. Int J Public Health. 2013;59(1):95-105
9.
Goodman E, Huang B. Socioeconomic status, depression, and health service utilization among adolescent women. Women's Health Issues. 2001;11(5):416–26.CrossRefPubMed
10.
Huisman M, Araya R, Lawlor DA, Ormel J, Verhulst FC, Oldehinkel AJ. Cognitive ability, parental socioeconomic position and internalising and externalising problems in adolescence: findings from two European cohort studies. Eur J Epidemiol. 2010;25(8):569–80.CrossRefPubMedPubMedCentral
11.
12.
Piko B, Fitzpatrick KM. Does class matter? SES and psychosocial health among Hungarian adolescents. Soc Sci Med. 2001;53(6):817–30.CrossRefPubMed
13.
Sonego M, Llacer A, Galan I, Simon F. The influence of parental education on child mental health in Spain. Qual Life Res. 2013;22(1):203–11.CrossRefPubMed
14.
Paananen R, Ristikari T, Merikukka M, Gissler M. Social determinants of mental health: a Finnish nationwide follow-up study on mental disorders. J Epidemiol Community Health. 2013;67(12):1025–31.CrossRefPubMed
15.
Aslund C, Leppert J, Starrin B, Nilsson KW. Subjective social status and shaming experiences in relation to adolescent depression. Arch Pediatr Adolesc Med. 2009;163(1):55–60.CrossRefPubMed
16.
Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med. 2013;90(0):24–31.CrossRefPubMed
17.
18.
McLaughlin KA, Breslau J, Green JG, Lakoma MD, Sampson NA, Zaslavsky AM, Kessler RC. Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample. Soc Sci Med. 2011;73(7):1088–96.CrossRefPubMedPubMedCentral
19.
Twenge JM, Nolen-Hoeksema S. Age, gender, race, socioeconomic status, and birth cohort differences on the children's depression inventory: a meta-analysis. J Abnorm Psychol. 2002;111(4):578–88.CrossRefPubMed
20.
Miech RA, Caspi A, Moffitt TE, Wright BRE, Silva PA. Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. Am J Sociol. 1999;104(4):1096–131.CrossRef
21.
Molarius A, Berglund K, Eriksson C, Eriksson HG, Linden-Bostrom M, Nordstrom E, Persson C, Sahlqvist L, Starrin B, Ydreborg B. Mental health symptoms in relation to socio-economic conditions and lifestyle factors--a population-based study in Sweden. BMC Public Health. 2009;9:302.CrossRefPubMedPubMedCentral
22.
Ostberg V, Lennartsson C. Getting by with a little help: the importance of various types of social support for health problems. Scand J Public Health. 2007;35(2):197–204.CrossRefPubMed
23.
Danielsson U. Träffad av blixten eller långsam kvävning: genuskodade uttryck för depression i en primärvårdskontext. Umeå: Umeå university; 2010.
24.
Wallerblad A, Moller J, Forsell Y. Care-seeking pattern among persons with depression and anxiety: a population-based study in Sweden. Int J Fam Med. 2012;2012:895425.
25.
Beardslee WR, Keller MB, Lavori PW, Staley J, Sacks N. The impact of parental affective disorder on depression in offspring: a longitudinal follow-up in a nonreferred sample. J Am Acad Child Adolesc Psychiatry. 1993;32(4):723–30.CrossRefPubMed
26.
Joinson C, Kounali D, Lewis G. Family socioeconomic position in early life and onset of depressive symptoms and depression: a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol. 2017;52(1):95–103.CrossRefPubMed
27.
Korhonen K, Remes H, Martikainen P. Education as a social pathway from parental socioeconomic position to depression in late adolescence and early adulthood: a Finnish population-based register study. Soc Psychiatry Psychiatr Epidemiol. 2017;52(1):105–16.CrossRefPubMed
28.
Spady DW, Schopflocher DP, Svenson LW, Thompson AH. Prevalence of mental disorders in children living in Alberta, Canada, as determined from physician billing data. Arch Pediatr & Adolesc Med. 2001;155(10):1153–9.CrossRef
29.
Tonge BJ, Hughes GC, Pullen JM, Beaufoy J, Gold S. Comprehensive description of adolescents admitted to a public psychiatric inpatient unit and their families. Aust N Z J Psychiatry. 2008;42(7):627–35.CrossRefPubMed
30.
Leve LD, Kim HK, Pears KC. Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17. J Abnorm Child Psychol. 2005;33(5):505–20.CrossRefPubMedPubMedCentral
31.
Due P, Lynch J, Holstein B, Modvig J. Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health. 2003;57(9):692–8.CrossRefPubMedPubMedCentral
32.
Frojd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R. Perceived financial difficulties and maladjustment outcomes in adolescence. Eur J Pub Health. 2006;16(5):542–8.CrossRef
33.
Roberts RE, Roberts CR, Xing Y. Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. J Psychiatr Res. 2007;41(11):959–67.CrossRefPubMed
34.
Mendelson T, Kubzansky LD, Datta GD, Buka SL. Relation of female gender and low socioeconomic status to internalizing symptoms among adolescents: a case of double jeopardy? Soc Sci Med. 2008;66(6):1284–96.CrossRefPubMed
35.
Statistics Sweden. Background facts, labour and education statistics 2011: 4. Stockholm: Integrated database for labour market research; 2011.
36.
37.
38.
Stockholm County Council. VAL databaserna - datalager för uppföljning av vårdhändelser i SLL. Stockholm läns landsting: Stockholm; 2014.
39.
Statistics Sweden: Background Facts, Population and Welfare Statistics 2011:2, Multi-generation register 2010. A description of contents and quality 2011.
40.
Statistics Sweden: SUN. Swedish standard for classification of individual educational programs 2000.
41.
Wang JL, Schmitz N, Dewa CS. Socioeconomic status and the risk of major depression: the Canadian National Population Health Survey. J Epidemiol Community Health. 2010;64(5):447–52.CrossRefPubMed
42.
Paul A. Survival analysis using SAS: a practical guide; second edition [electronic resource]: North Carolina: SAS Institute; 2010.
43.
Lundberg M, Fredlund P, Hallqvist J, Diderichsen F. A SAS program calculating three measures of interaction with confidence intervals. Epidemiol. 1996;7(6):655–6.
44.
Rothman KJ. In: GS RKJ, Lash TL, editors. Modern epidemiology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2008.
45.
46.
Elovainio M, Pulkki-Raback L, Jokela M, Kivimaki M, Hintsanen M, Hintsa T, Viikari J, Raitakari OT, Keltikangas-Jarvinen L. Socioeconomic status and the development of depressive symptoms from childhood to adulthood: a longitudinal analysis across 27 years of follow-up in the young Finns study. Soc Sci Med. 2012;74(6):923–9.CrossRefPubMed
47.
Kaltiala-Heino R, Rimpela M, Rantanen P, Laippala P. Adolescent depression: the role of discontinuities in life course and social support. J Affect Disord. 2001;64(2–3):155–66.CrossRefPubMed
48.
Aslund C, Nilsson KW, Starrin B, Sjoberg RL. Shaming experiences and the association between adolescent depression and psychosocial risk factors. Eur Child Adolesc Psychiatry. 2007;16(5):298–304.CrossRefPubMed
49.
West P. Health inequalities in the early years: is there equalisation in youth? Soc Sci Med. 1997;44(6):833–58.CrossRefPubMed
50.
Chen E, Martin AD, Matthews KA. Socioeconomic status and health: do gradients differ within childhood and adolescence? Soc Sci Med. 2006;62(9):2161–70.CrossRefPubMed
51.
Spencer NJ. Social equalization in youth: evidence from a cross-sectional British survey. Eur J Pub Health. 2006;16(4):368–75.CrossRef
52.
Swedish National Institute of Public Health: Survey of mental health among children and adolescents. Results of the national total population study in grades 6 and 9, autumn 2009. Mölnlycke: Swedish National Institute of Public Health; 2011.
53.
Ivert AK, Merlo J, Svensson R, Levander MT. How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents? Soc Psychiatry Psychiatr Epidemiol. 2013;48(5):693–9.CrossRefPubMed
54.
Niemi ME, Falkenberg T, Nguyen MTT, Nguyen MTN, Patel V, Faxelid E. The social contexts of depression during motherhood: a study of explanatory models in Vietnam. J Affect Disord. 2010;124(1–2):29–37.CrossRefPubMed
55.
SBU. Treatment of Depression. A Systematic Review. Stockholm: The Swedish Council on Technology Assessment in Health Care (SBU); 2004.
56.
Mackenbach JP. Health inequalities : Europe in profile. London: Produced by COI for the Dept. of Health; 2006.
57.
Wirback T, Forsell Y, Larsson J-O, Engstrom K, Edhborg M. Experiences of depression and help-seeking described by young Swedish men. Psychol Men Masc. Advance online publication 2017.
58.
Muntaner C, Eaton WW, Miech R, O'Campo P. Socioeconomic position and major mental disorders. Epidemiol Rev. 2004;26:53–62.CrossRefPubMed
59.
Ritsher JE, Warner V, Johnson JG, Dohrenwend BP. Inter-generational longitudinal study of social class and depression: a test of social causation and social selection models. British J Psychiatry Suppl. 2001;40:s84–90.CrossRef
60.
Cyranowski JM, Frank E, Young E, Shear MK. Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch Gen Psychiatry. 2000;57(1):21–7.CrossRefPubMed
61.
Courtenay WH. Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Soc Sci Med. 2000;50(10):1385–401.CrossRefPubMed
62.
Ochi M, Fujiwara T, Mizuki R, Kawakami N, Grp WMHJS. Association of socioeconomic status in childhood with major depression and generalized anxiety disorder: results from the world mental health Japan survey 2002-2006. BMC Public Health. 2014;14 https://​doi.​org/​10.​1186/​1471-2458-14-359.
63.
Geyer S, Hemstrom O, Peter R, Vagero D. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health. 2006;60(9):804–10.CrossRefPubMedPubMedCentral
64.
Fors S, Lennartsson C, Lundberg O. Childhood living conditions, socioeconomic position in adulthood, and cognition in later life: exploring the associations. J Gerontol Ser B Psychol Sci Soc Sci. 2009;64(6):750–7.CrossRef
65.
Socialstyrelsen. Folkhälsorapport 2009. Stockholm: Socialstyrelsen; 2009.
66.
Jaffee SR, Moffitt TE, Caspi A, Fombonne E, Poulton R, Martin J. Differences in early childhood risk factors for juvenile-onset and adult-onset depression. Arch Gen Psychiatry. 2002;59(3):215–22.CrossRefPubMed
67.
Jorgensen L, Ahlbom A, Allebeck P, Dalman C. The Stockholm non-affective psychoses study (snaps): the importance of including out-patient data in incidence studies. Acta Psychiatr Scand. 2010;121(5):389–92.CrossRefPubMed
68.
Allebeck P. The use of population based registers in psychiatric research. Acta Psychiatr Scand. 2009;120(5):386–91.CrossRefPubMed
69.
Fazel S, Wolf A, Chang Z, Larsson H, Goodwin GM, Lichtenstein P. Depression and violence: a Swedish population study. Lancet Psychiat. 2015;2(3):224–32.CrossRef
70.
Essau CA. Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depressn Anxiety. 2005;22(3):130–7.CrossRefPubMed
71.
Wasserman D: Depression-en vanlig sjukdom. Stockholm: Natur och Kultur; 2010.
72.
Paananen R, Santalahti P, Merikukka M, Ramo A, Wahlbeck K, Gissler M. Socioeconomic and regional aspects in the use of specialized psychiatric care--a Finnish nationwide follow-up study. Eur J Pub Health. 2013;23(3):372–7.CrossRef
73.
Zwaanswijk M, Verhaak PF, Bensing JM, van der Ende J, Verhulst FC. Help seeking for emotional and behavioural problems in children and adolescents: a review of recent literature. Eur Child Adolesc Psychiatry. 2003;12(4):153–61.CrossRefPubMed
74.
Modin B, Ostberg V, Almquist Y. Childhood peer status and adult susceptibility to anxiety and depression. A 30-year hospital follow-up. J Abnorm Child Psychol. 2011;39(2):187–99.CrossRefPubMed
75.
Patterson V, Mackenzie L, Zwicker A, Drobinin V, Cumby J, Abidi S, Bagnell A, Propper L, Alda M, Uher R. Adversity, parental mental illness, and risk of depression in youth. Eur Psychiat. 2017;41:S220.CrossRef
Metadata
Title
Social differences in diagnosed depression among adolescents in a Swedish population based cohort
Authors
Therese Wirback
Jette Möller
Jan-Olov Larsson
Karin Engström
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1765-0

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