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Associations between subjective social status and DSM-IV mental disorders: results from the World Mental Health surveys

dc.creatorScott, K.M.
dc.creatorAl-Hamzawi, A.O.
dc.creatorAndrade, L.H.
dc.creatorBorges, G.
dc.creatorCaldas-de-Almeida, J.M.
dc.creatorFiestas, F.
dc.creatorGureje, O.
dc.creatorHu, C.Y.
dc.creatorKaram, E.G.
dc.creatorKawakami, N.
dc.creatorLee, S.
dc.creatorLevinson, D.
dc.creatorLim, C.C.W.
dc.creatorNavarro-Mateu, F.
dc.creatorOkoliyski, M.
dc.creatorPosada-Villa, J.
dc.creatorTorres, Y.
dc.creatorWilliams, D.R.
dc.creatorZakhozha, V.
dc.creatorKessler, R.C.
dc.date.accessioned2017-06-29T03:42:19Z
dc.date.available2017-06-29T03:42:19Z
dc.date.issued2014es_ES
dc.identifier2568es_ES
dc.identifier.issn2168-622Xes_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/4417
dc.identifier.urihttp://doi.org/10.1001/jamapsychiatry.2014.1337es_ES
dc.description.abstractes_ES
dc.language.isoenges_ES
dc.publisheres_ES
dc.relation71(12) 1400-1408p.es_ES
dc.relationversión del editores_ES
dc.rightsacceso cerradoes_ES
dc.subject.meshAdolescentes_ES
dc.subject.meshAdultes_ES
dc.subject.meshAgedes_ES
dc.subject.meshAnxiety Disorders/epidemiologyes_ES
dc.subject.meshDiagnostic and Statistical Manual of Mental Disorderses_ES
dc.subject.meshDisruptive, Impulse Control, and Conduct Disorders/epidemiologyes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHealth Surveyses_ES
dc.subject.meshHumanses_ES
dc.subject.meshMalees_ES
dc.subject.meshMiddle Agedes_ES
dc.subject.meshMood Disorders/epidemiologyes_ES
dc.subject.meshPrevalencees_ES
dc.subject.meshSocial Classes_ES
dc.subject.meshYoung Adultes_ES
dc.titleAssociations between subjective social status and DSM-IV mental disorders: results from the World Mental Health surveyses_ES
dc.title.alternativees_ES
dc.typeartículoes_ES
dc.contributor.affiliationDepartment of Psychological Medicine, University of Otago, Dunedin, New Zealandes_ES
dc.contributor.emailkate.scott@otago.ac.nzes_ES
dc.relation.jnabreviadoJAMA PSYCHIATRYes_ES
dc.relation.journalJAMA Psychiatryes_ES
dc.identifier.placeEstados Unidoses_ES
dc.date.published2014es_ES
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñizes_ES
dc.identifier.eissn2168-6238es_ES
dc.identifier.doi10.1001/jamapsychiatry.2014.1337es_ES
dc.description.monthDices_ES
dc.description.abstractotrodiomaIMPORTANCE:  The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures, such as educational level, income, and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture the perception of relative social status, but to our knowledge, there have been no studies of associations between SSS and mental disorders. OBJECTIVES:  To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS. DESIGN, SETTING, AND PARTICIPANTS:  Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, and the Middle East (N=56,085). Subjective social status was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, educational level, and occupation. Scores on the 1 to 10 SSS scale were categorized into 4 categories: low (scores 1-3), low-mid (scores 4-5), high-mid (scores 6-7), and high (scores 8-10). Objective social status was assessed with a wide range of fine-grained objective indicators of income, educational level, and occupation. MAIN OUTCOMES AND MEASURES:  The Composite International Diagnostic Interview assessed the 12-month prevalence of 16 DSM-IV mood, anxiety, and impulse control disorders. RESULTS:  The weighted mean survey response rate was 75.2% (range, 55.1%-97.2%). Graded inverse associations were found between SSS and all 16 mental disorders. Gross odds ratios (lowest vs highest SSS categories) in the range of 1.8 to 9.0 were attenuated but remained significant for all 16 disorders (odds ratio, 1.4-4.9) after adjusting for OSS indicators. This pattern of inverse association between SSS and mental disorders was significant in 14 of 18 individual countries, and in low-, middle-, and high-income country groups but was significantly stronger in high- vs lower-income countries. CONCLUSIONS AND RELEVANCE:  Significant inverse associations between SSS and numerous DSM-IV mental disorders exist across a wide range of countries even after comprehensive adjustment for OSS. Although it is unclear whether these associations are the result of social selection, social causation, or both, these results document clearly that research relying exclusively on standard OSS measures underestimates the steepness of the social gradient in mental disorders.es_ES
dc.subject.meshmes_ES
dc.subject.kwes_ES
dc.subject.koSelf-rated healthes_ES
dc.subject.koSocioeconomic-statuses_ES
dc.subject.koPsychiatric-disorderses_ES
dc.subject.koAfrican-americanses_ES
dc.subject.koWhitehall-iies_ES
dc.subject.koSelectiones_ES
dc.subject.koIncomees_ES
dc.subject.koWomenes_ES
dc.subject.koReliabilityes_ES
dc.subject.koInequalityes_ES


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