RCPsych: Effects of social class in childhood and adulthood on depression and anxiety in middle age

A new study has found that socioeconomic position in adulthood has more influence on psychological problems in midlife than social class in childhood.

For women, lower social class (manual socioeconomic position) at age 42 is linked to depression and other mental health problems, although this effect is reduced when childhood psychological disorders are taken into account.

Published in the February 2008 issue of the British Journal of Psychiatry, this is one of very few studies examining the links between childhood socioeconomic position and midlife depressive and anxiety disorders.

The researchers used information from the 1958 British Birth Cohort, which has been followed up at ages 7, 11, 16, 23, 33 and 42, with a biomedical follow-up at age 45.

11,971 participants still in contact with the study at the age of 45 were invited to a biomedical assessment that included measurement of eyesight, respiratory function, hearing, and a computer-assisted personal interview. 9377 people responded, a response rate of 72% of the contacted sample.

Both men and women were given a 'manual' or 'non-manual' occupational status. Childhood socioeconomic position at 7 years of age was measured by the father's occupation.

Depressive and anxiety disorders in the previous week were assessed, along with 'any diagnosis', which included generalised anxiety disorder, depressive episode, any phobia and panic disorder.

Psychological distress at ages 7 and 11 was measured, as well as psychological difficulties at age 16. The effects of adulthood socioeconomic position on the association between childhood socioeconomic position and midlife disorder were also assessed.

It was found that at the age of 45, 6% of the total sample met the criteria for 'any diagnosis' (7.2% of women; 4.8% of men). Manual social position at 7 years of age was associated with a small increased risk for any diagnosis at age 45, but this association no longer held when adult socioeconomic position was taken into account.

Manual socioeconomic position at 42 years of age was associated with a significantly increased risk of any diagnosis and depressive episode in women, but not in men.

The researchers comment that the loss of the small association between manual socioeconomic position in childhood, and any diagnosis in midlife after adult socioeconomic position is taken into account, suggests that the effects of childhood socioeconomic position are mainly influenced by adult socioeconomic position, through pathways that lead from disadvantaged childhoods to disadvantaged adulthoods.

The effects of less advantaged socioeconomic position in adulthood are not primarily the result of childhood socioeconomic position. Less advantaged socioeconomic position in childhood did not account for the association of adult socioeconomic position and midlife disorders.

Any diagnosis and depressive episode were strongly influenced by adult social disadvantage, as has been shown in other birth cohort studies. In addition, decline in socioeconomic status has also been linked to an increased risk of depression.

For further information contact Dr. Stephen Stansfeld, Wolfson Institute of Preventive Medicine, London.
Tel: 020 7882 2021/31
E-mail: S.A.Stansfeld@qmul.ac.uk

Reference

Stansfeld SA, Clark C, Rodgers B, Caldwell T and Power C (2008) Childhood and adulthood socio-economic position and midlife depressive and anxiety disorders. British Journal of Psychiatry, 192, 152-153.

For further information, or a press copy of the full paper, please contact Deborah Hart or Thomas Kennedy in the External Affairs Department.

Telephone: 020 7235 2351 Extensions. 127 or 154
E-mail: dhart@rcpsych.ac.uk or tkennedy@rcpsych.ac.uk.