title: Repeated exposure to socioeconomic disadvantage and health selection as life course pathways to mid-life depressive and anxiety disorders.
abstract: BACKGROUND
  Socioeconomic position (SEP) in childhood and adulthood influences the risk of adult psychiatric disorder. This paper investigates first how cumulative childhood manual SEP influences the risk for mid-life depressive and anxiety disorders and secondly the effects of health selection based on psychological disorder in childhood and psychological distress in early adulthood on mid-life social position.
  
  
  METHODS
  9,377 participants of the 1958 Birth Cohort were followed up at 45 years with the Revised Clinical Interview Schedule to measure depressive and anxiety disorders. SEP was measured by Registrar General Social Class in childhood (ages 7, 11 and 16 years) and adulthood (ages 23, 33 and 42 years). Internalising and externalising disorders were also measured in childhood.
  
  
  RESULTS
  Cumulative manual SEP in childhood was weakly associated with increased risk of mid-life disorder. Childhood internalising and externalising disorders were associated with less upward social mobility and manual adult social position. Psychological disorder on three occasions in childhood was associated with manual adult occupational status (OR = 3.33, 95% CI 2.63-4.21) even after adjusting for childhood SEP and malaise score at 42 years.
  
  
  CONCLUSIONS
  Both social causation and health selection contribute to the association of childhood socioeconomic disadvantage and mid-life depressive and anxiety disorders. Tackling accumulation of disadvantage and understanding and treating childhood psychological disorders and their educational and occupational consequences could reduce the risk of mid-life psychiatric disorders.
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK. S.A.Stansfeld@qmul.ac.uk
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.forename: Bryan
authors.initials: B
authors.lastname: Rodgers
authors.forename: Tanya
authors.initials: T
authors.lastname: Caldwell
authors.forename: Chris
authors.initials: C
authors.lastname: Power
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders; D002648:Child; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D013995:Time; D006113:United Kingdom; D055815:Young Adult
references.citation: Br J Psychiatry. 2006 Aug;189:109-17
references.pmid: 16880479
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2003 May;38(5):229-37
references.pmid: 12719837
references.citation: J Epidemiol Community Health. 2001 Oct;55(10):693-700
references.pmid: 11553651
references.citation: Soc Sci Med. 2002 Mar;54(5):783-98
references.pmid: 11999493
references.citation: J Epidemiol Community Health. 2006 Jan;60(1):7-12
references.pmid: 16361448
references.citation: Int J Epidemiol. 2006 Feb;35(1):34-41
references.pmid: 16155052
references.citation: J Epidemiol Community Health. 2006 Dec;60(12):1080-4
references.pmid: 17108306
references.citation: J Abnorm Psychol. 1999 Aug;108(3):490-9
references.pmid: 10466273
references.citation: Br J Psychiatry Suppl. 2001 Apr;40:s84-90
references.pmid: 11315232
references.citation: Soc Sci Med. 2002 Dec;55(11):1989-2004
references.pmid: 12406466
references.citation: Br J Psychiatry. 2008 Feb;192(2):152-3
references.pmid: 18245036
references.citation: J R Coll Physicians Lond. 1970 Apr;4(3):211-8
references.pmid: 4107172
references.citation: Soc Sci Med. 2005 Dec;61(11):2272-6; discussion 2277-9
references.pmid: 16174546
references.citation: Arch Gen Psychiatry. 2007 Jun;64(6):668-78
references.pmid: 17548748
references.citation: Ann Epidemiol. 2007 Apr;17(4):289-95
references.pmid: 17174566
references.citation: Am J Epidemiol. 2003 Jan 15;157(2):98-112
references.pmid: 12522017
references.citation: Int J Epidemiol. 2007 Jun;36(3):532-9
references.pmid: 17255345
references.citation: Int J Epidemiol. 2002 Apr;31(2):285-93
references.pmid: 11980781
references.citation: Lancet. 2002 Nov 23;360(9346):1640-5
references.pmid: 12457787
references.citation: Ciba Found Symp. 1991;156:189-200; discussion 200-8
references.pmid: 1855412
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2009 May;44(5):421-7
references.pmid: 18979222
references.citation: J Health Econ. 2005 Mar;24(2):365-89
references.pmid: 15721050
references.citation: Int J Epidemiol. 2007 Aug;36(4):776-86
references.pmid: 17517811
references.citation: Int J Epidemiol. 2005 Apr;34(2):344-5
references.pmid: 15746203
references.citation: Am J Public Health. 1999 Jul;89(7):1059-65
references.pmid: 10394316
references.citation: Int J Epidemiol. 2002 Apr;31(2):359-67
references.pmid: 11980797
references.citation: Soc Sci Med. 2002 Sep;55(5):863-80
references.pmid: 12190276
references.citation: Soc Sci Med. 1999 Jan;48(1):49-60
references.pmid: 10048837
references.citation: BMJ. 2009 Jun 29;338:b2393
references.pmid: 19564179
references.citation: J Epidemiol Community Health. 2002 Sep;56(9):647-52
references.pmid: 12177079
references.citation: Soc Sci Med. 2002 Dec;55(11):1957-73
references.pmid: 12406464
references.citation: Soc Psychiatry Psychiatr Epidemiol. 1999 Jun;34(6):333-41
references.pmid: 10422488
references.citation: Soc Psychiatry Psychiatr Epidemiol. 1992 Nov;27(6):284-91
references.pmid: 1492248
references.citation: J Epidemiol Community Health. 2008 Mar;62(3):216-23
references.pmid: 18272736
references.citation: Psychol Methods. 2002 Mar;7(1):83-104
references.pmid: 11928892
references.citation: Psychol Med. 1995 Jan;25(1):7-21
references.pmid: 7792364
references.citation: Science. 1992 Feb 21;255(5047):946-52
references.pmid: 1546291
references.citation: Soc Sci Med. 2003 Dec;57(11):2217-27
references.pmid: 14512251
references.citation: Int Rev Psychiatry. 2003 Feb-May;15(1-2):91-6
references.pmid: 12745315
references.citation: Int J Epidemiol. 2002 Apr;31(2):395-403
references.pmid: 11980802
references.citation: J Epidemiol Community Health. 1996 Aug;50(4):415-22
references.pmid: 8882225