The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe)


Background:
Low socio-economic status (SES) has been found to be associated with a higher prevalence of depression. However, studies that have investigated this association have been limited in their national scope, have analyzed different components of SES separately, and have not used standardized definitions or measurements across populations. The aim of the current study was to evaluate the association between SES and depression across three European countries that represent different regions across Europe, using standardized procedures and measurements and a composite score for SES.

Method:
Nationally-representative data on 10,800 individuals aged ≥18 from the Collaborative Research on Ageing in Europe (COURAGE) survey conducted in Finland, Poland and Spain were analyzed in this cross-sectional study. An adapted version of the Composite International Diagnostic Interview was used to identify the presence of depression, and SES was computed by using the combined scores of the total number of years educated (0–22) and the quintiles of the country-specific income level of the household (1–5). Multivariable logistic regression was used to assess the association between SES and depression.

Results:
Findings reveal a significant association between depression and SES across all countries (p ≤ 0.001). After adjusting for confounders, the odds of depression were significantly decreased for every unit increase in the SES index for Finland, Poland and Spain. Additionally, higher education significantly decreased the odds for depression in each country, but income did not.

Conclusion:
The SES index seems to predict depression symptomatology across European countries. Taking SES into account may be an important factor in the development of depression prevention strategies across Europe.

Keywords:
Depression, Socioeconomic status, Cross-national, Income, Education


Autoři: Aislinne Freeman 1;  Stefanos Tyrovolas 2,3;  Ai Koyanagi 2,3;  Somnath Chatterji 3;  Matilde Leonardi 4;  Jose Luis Ayuso-Mateos 5,6;  Beata Tobiasz-Adamczyk 7;  Seppo Koskinen 8;  Christine Rummel-Kluge 1;  And Josep Maria Haro 2,5,9*
Působiště autorů: Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Leipzig, Leipzig, Germany. 1;  Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu/CIBERSAM, Dr. Antoni Pujadas, 2, Sant Boi de Llobregat, 088 0 Barcelona, Spain. 2;  Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland. 3;  Department of Neurology, Public Health and Disability, Italian National Neurological Institute “Carlo Besta” Foundation IRCCS (Istituto di ricovero e curaa carattere scientifico), Milan, Italy. 4;  Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 2 02 Madrid, Spain. 5;  Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain. 6;  Epidemiology and Preventive Medicine, Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland. 7;  National Institute for Health and Welfare, Helsinki, Finland. 8;  Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain. 9
Vyšlo v časopise: BMC Public Health 2016, 16:1098
Kategorie: Research article
prolekare.web.journal.doi_sk: 10.1186/s12889-016-3638-0

© 2016 The Author(s).

Open access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3638-0

Souhrn

Background:
Low socio-economic status (SES) has been found to be associated with a higher prevalence of depression. However, studies that have investigated this association have been limited in their national scope, have analyzed different components of SES separately, and have not used standardized definitions or measurements across populations. The aim of the current study was to evaluate the association between SES and depression across three European countries that represent different regions across Europe, using standardized procedures and measurements and a composite score for SES.

Method:
Nationally-representative data on 10,800 individuals aged ≥18 from the Collaborative Research on Ageing in Europe (COURAGE) survey conducted in Finland, Poland and Spain were analyzed in this cross-sectional study. An adapted version of the Composite International Diagnostic Interview was used to identify the presence of depression, and SES was computed by using the combined scores of the total number of years educated (0–22) and the quintiles of the country-specific income level of the household (1–5). Multivariable logistic regression was used to assess the association between SES and depression.

Results:
Findings reveal a significant association between depression and SES across all countries (p ≤ 0.001). After adjusting for confounders, the odds of depression were significantly decreased for every unit increase in the SES index for Finland, Poland and Spain. Additionally, higher education significantly decreased the odds for depression in each country, but income did not.

Conclusion:
The SES index seems to predict depression symptomatology across European countries. Taking SES into account may be an important factor in the development of depression prevention strategies across Europe.

Keywords:
Depression, Socioeconomic status, Cross-national, Income, Education


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