Social factors in childhood and risk of depressive symptoms among adolescents--a longitudinal study in Stockholm, Sweden.
BACKGROUND
In Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced. Therefore, the aim was to investigate whether multiple measures of low social status in childhood affect depressive symptoms in adolescence. A secondary aim was to explore potential gender effect modification.


METHODS
Participants were recruited in 1998 for a longitudinal study named BROMS. The study population at baseline consisted of 3020 children, 11-12 years-old, from 118 schools in Stockholm County, followed up through adolescence. This study is based on 1880 adolescents answering the follow-up survey in 2004, at age 17-18 (62% of the initial cohort). Parental education, occupation, country of birth, employment status and living arrangements were reported at baseline, by parents and adolescents. Depressive symptoms were self-reported by the adolescents in 2004, using a 12-item inventory. The associations between childhood social status and depressive symptoms in adolescence are presented as Odds Ratios (OR), estimated through logistic regression. Gender interaction with social factors was estimated through Synergy Index (SI).


RESULTS
Increased risk of depressive symptoms was found among adolescents whose parents had low education (OR 1.8, CI = 1.1-3.1), were unskilled workers (OR 2.1, CI = 1.2-3.7), intermediate non-manual workers (OR 1.8, CI = 1.0-3.0), or self-employed (OR 2.2, CI = 1.2-3.7), compared to parents with high education and high non-manual work. In addition, adolescents living exclusively with one adult had an increased risk compared to those living with two (OR 2.8, CI = 1.1-7.5), while having foreign-born parents was not associated with depressive symptoms. An interaction effect was seen between gender and social factors, with an increased risk for girls of low-educated parents (SI = 3.4, CI = 1.3-8.9) or living exclusively with one adult (SI = 4.9, CI = 1.4-6.8).


CONCLUSIONS
The low social position in childhood may increase the risk of depressive symptoms among adolescents even in countries with small social differences and a highly developed welfare system, such as Sweden. Girls with low educated parents or living exclusively with one adult may be particularly vulnerable. This knowledge is of importance when planning preventive interventions or treatment.
Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. therese.wirback@ki.se.
Therese
T
Wirback
Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. jette.moller@ki.se.
Jette
J
Möller
Department of Women's and Children's Health, FoUU BUP, q3:4 Astrid Lindgren Children's Hospital, 171 77, Stockholm, Sweden. jan-olov.larsson@ki.se.
Jan-Olov
JO
Larsson
Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. rosaria.galanti@ki.se.|Centre for Epidemiology and Community Medicine, Stockholm County Council, 171 77, Stockholm, Sweden. rosaria.galanti@ki.se.
Maria Rosaria
MR
Galanti
Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. karin.engstrom@ki.se.|Centre for Epidemiology and Community Medicine, Stockholm County Council, 171 77, Stockholm, Sweden. karin.engstrom@ki.se.
Karin
K
Engström
D000293:Adolescent; D002648:Child; D003863:Depression / Q000453:epidemiology*; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009790:Occupations / Q000706:statistics & numerical data; D016017:Odds Ratio; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology