Social position and the common mental disorders with disability: estimates from the National Psychiatric Survey of Great Britain.
BACKGROUND
Published studies linking the common mental disorders with social disadvantage lack basic comparability. This project aimed to estimate effect sizes and independence of social position markers as risk factors for common mental disorders. Disorders with disability were examined to identify groups with high clinical and policy priority.


METHODS
Data from the 1993 household survey of psychiatric morbidity in Great Britain were analysed using logistic regression models, using traditional and more specific markers of social position.


RESULTS
Of those with a common mental disorder, 22 % reported difficulty doing at least one activity of daily living, linked to their mental symptoms. In comprehensive statistical analyses, having two or more physical illnesses was associated with an odds ratio of 6.42 (95 % CI 4.34-9.51) for common mental disorder with disability, while odds ratios of 3 or more were present for being economically inactive or having had two or more recent adverse life events. Occupational social class was not an independent marker of raised rates of disorder. Similar patterns of result were present for common mental disorders irrespective of disability, although odds ratios were smaller.


CONCLUSIONS
Several specific markers of less privileged status are independently associated with raised rates of common mental disorders, with or without disability. There may be scope to target specific high-risk groups within comprehensive programmes to reduce mental health inequalities.
Department of Public Health and Primary Care, Institute of Public Health, Forvie Site, Robinson Way, Cambridge CB2 2SR, UK. dm214@medschl.cam.ac.uk
David
D
Melzer
Tom
T
Fryers
Rachel
R
Jenkins
Terry
T
Brugha
Brenda
B
McWilliams
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D012935:Social Justice; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D035862:Vulnerable Populations