Social Class, Social Mobility and Risk of Psychiatric Disorder - A Population-Based Longitudinal Study

Abstract

ObjectivesThis study explored how adult social class and social mobility between parental and own adult social class is related to psychiatric disorder.Material and MethodsIn this prospective cohort study, over 1 million employed Swedes born in 1949-1959 were included. Information on parental class (1960) and own mid-life social class (1980 and 1990) was retrieved from the censuses and categorised as High Non-manual, Low Non-manual, High Manual, Low Manual and Self-employed. After identifying adult class, individuals were followed for psychiatric disorder by first admission of schizophrenia, alcoholism and drug dependency, affective psychosis and neurosis or personality disorder (N=24 659) from the Swedish Patient Register. We used Poisson regression analysis to estimate first admission rates of psychiatric disorder per 100 000 person-years and relative risks (RR) by adult social class (treated as a time-varying covariate). The RRs of psychiatric disorder among the Non-manual and Manual classes were also estimated by magnitude of social mobility.ResultsThe rate of psychiatric disorder was significantly higher among individuals belonging to the Low manual class as compared with the High Non-manual class. Compared to High Non-manual class, the risk for psychiatric disorder ranged from 2.07 (Low Manual class) to 1.38 (Low Non-manual class). Parental class had a minor impact on these estimates. Among the Non-manual and Manual classes, downward mobility was associated with increased risk and upward mobility with decreased risk of psychiatric disorder. In addition, downward mobility was inversely associated with the magnitude of social mobility, independent of parental class.ConclusionsIndependently of parental social class, the risk of psychiatric disorder increases with increased downward social mobility and decreases with increased upward mobility.

Psychiatric disorder and work life: A longitudinal study of intra-generational social mobility

“…We observed large differences in social stability for EPD and the comparison group. Previous research on inter-generational social mobility showed that the risk of psychiatric disorder increases with increased downward social mobility and decreases with increased upward mobility among Non-manual and Manual classes (Tiikkaja et al, 2013) Our results are in accordance with the assumption that improvement in the daily life of psychiatric patients should include work rehabilitation to enable EPD to remain in the labour force and maintain social stability.…”

Social mobility and the well‐being of individuals

“… Using population register data from Sweden, Tiikkaja et al (: 1) show that ‘downward mobility was associated with increased risk and upward mobility with decreased risk of psychiatric disorder’.…”

Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study

“…Mortality in hip fracture patients may also be influenced by socioeconomic status,33 and Marinacci et al found an association between lower education level and mortality 34. Lower education level is further associated with increased risk of psychiatric admission due to schizophrenia, alcoholism, drug dependency, affective psychosis, neurosis, and personality disorder 35. Finally, Seitz et al found no difference in 30-day mortality between current (9.1%) and former (9.4%) serotonergic antidepressant users undergoing hip fracture surgery 36.…”