Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-29T03:09:29.719Z Has data issue: false hasContentIssue false
  • English
  • Français

Socio-economic Mobility among Patients with Schizophrenia or Major Affective Disorder a 17-Year Retrospective Follow-Up

Published online by Cambridge University Press:  02 January 2018

Seppo Aro ,
Hillevi Aro  and
Ilmo Keskimäki
Seppo Aro*
Affiliation:
National Research and Development Centre for Welfare and Health, Helsinki
Hillevi Aro
Affiliation:
National Public Health Institute, Department of Mental Health, Helsinki
Ilmo Keskimäki
Affiliation:
National Research and Development Centre for Welfare and Health, Helsinki, Finland
*
Professor Seppo Aro, National Research and Development Centre for Welfare and Health, Health Services Research Unit, PO Box 220, FIN-00531 Helsinki, Finland
Get access Rights & Permissions [Opens in a new window]

Extract

Background

Social mobility among patients with schizophrenia or major affective disorder was compared with that among the general population.

Method

Mobility was studied retrospectively from 1970 to 1987. Socio-economic status (SES) was defined by occupation as in the population census (upper white-collar, lower white-collar, blue-collar, entrepreneur, farmer, unemployed). All patients aged 30–60 years at discharge (2901 men and 3620 women) in 1987–88 in Finland were included in the study. The SES structure of the general population was used for comparisons.

Results

Among patients with schizophrenia there was a constant downward drift, commonly to unemployment. This risk was higher among men than women. In the youngest age group a marked decline from the parents' social status was observed. Among patients with major affective disorder the distribution of SES in 1970 was similar to that of the general population. By 1987, a downward drift was again observed, mainly to unemployment regardless of the initial SES group. The number of patients in occupational categories were usually 30–50% lower than expected.

Conclusions

Schizophrenic patients had a high risk of social drop-out. Among patients with major affective disorder the downward drift was much less.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 6 , June 1995 , pp. 759 - 767
Copyright
Copyright © Royal College of Psychiatrists, 1995 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Birtchnell, J. (1971) Social class, parental social class, and social mobility in psychiatric patients and general population controls. Psychological Medicine, 1, 209–221.Google Scholar
Dohrenwend, B. P. (1990) Socioeconomic status (SES) and psychiatric disorders. Are the issues still compelling? Social Psychiatry and Psychiatric Epidemiology, 25, 41–47.Google Scholar
Eaton, W. W. (1985) Epidemiology of schizophrenia. Epidemiologic Reviews, 7, 105–126.Google Scholar
Eaton, W. W. & Kessler, L. G. (1981) Rates of symptoms of depression in a national sample. American Journal of Epidemiology, 114, 528–538.Google Scholar
Gift, T. E., Strauss, J. S., Ritzler, B. A., et al (1986) Social class and psychiatric outcome. American Journal of Psychiatry, 143, 222–225.Google Scholar
Goldberg, E. M. & Morrison, S. L. (1963) Schizophrenia and social class. British Journal of Psychiatry, 109, 785–802.Google Scholar
Harder, D. W., Strauss, J. S., Greenwald, D. F., et al (1990) Predictors of outcome among adult psychiatric first-admissions. Journal of Clinical Psychology, 46, 119–128.Google Scholar
Hirschfeld, R. M. A. & Cross, C. K. (1982) Epidemiology of affective disorders. Psychosocial risk factors. Archives of General Psychiatry, 39, 35–46.Google Scholar
Hollingshead, A. B. & Redlich, F. C. (1958) Social Class and Mental Illness. New York: Wiley.Google Scholar
Holzer, C. E., Shea, B. M., Swanson, J. W., et al (1986) The increased risk for specific psychiatric disorders among persons of low socioeconomic status. Evidence from the Epidemiologic Catchment Area Surveys. American Journal of Social Psychiatry, 6, 259–271.Google Scholar
Jones, P. B., Bebbington, P., Foerster, A., et al (1993) Premorbid social underachievement in schizophrenia. Results from the Camberwell Collaborative Psychosis Study. British Journal of Psychiatry, 162, 65–71.Google Scholar
Keskimäki, I. & Aro, S. (1991) Accuracy of data on diagnosis, procedures and accidents in Finnish Hospital Discharge Register. International Journal of Health Sciences, 2, 15–21.Google Scholar
Kleinbaum, D. G., Kupper, L. L. & Morgenstern, H. (1982) Epidemiologic Research. Principles and Quantitative Methods. London: Lifetime Learning.Google Scholar
Kloreman, R., Strauss, J. S. & Kokes, R. F. (1977) Premorbid adjustments in schizophrenia: concepts, measures, and implications. II. The relationship of demographic and diagnostic factors to measures of premorbidity in schizophrenia. Schizophrenia Bulletin, 3, 214–245.CrossRefGoogle Scholar
Kohn, M. L. (1973) Social class and schizophrenia: a critical review and a reformulation. Schizophrenia Bulletin, 1, 60–79.CrossRefGoogle Scholar
Lehtinen, V. & Joukamaa, M. (1994) Epidemiology of depression: prevalence, risk factors and treatment situations. Acta Psychiatrica Scandinavica, (suppl. 377), 7–10.Google Scholar
Marneros, A., Steinmeyer, E.M., Deister, A., et al (1989) Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. III. Social consequences. European Archives of Psychiatry and Neurological Sciences, 238, 135–139.Google Scholar
Marneros, A., Deister, A. & Rohde, A. (1990) Psychopathological and social status of patients with affective, schizophrenic and schizoaffective disorders after long-term course. Acta Psychiatrica Scandinavica, 82, 352–358.Google Scholar
National Agency for Welfare and Health (1992) Census of Patients in Psychiatric Wards 1984–1991 (Health 7). Helsinki: National Agency for Welfare and Health.Google Scholar
Pakaslahti, A. (1987) On the diagnosis of schizophrenic psychoses in clinical practice. Psychiatria Fennica, 18, 63–72.Google Scholar
Weissman, M. M. & Myers, J. K. (1978) Affective disorders in a US urban community. The use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry, 35, 1304–1311.Google Scholar
Wiersma, D., Giel, R., De Jong, A., et al (1983) Social class and schizophrenia in a Dutch cohort. Psychological Medicine, 13, 141–150.CrossRefGoogle Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.