Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women

Background The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed count...

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Main Authors: Shi, J, Zhang, Y, Liu, F, Li, Y, Wang, J, Flint, J, Gao, J, Tao, M, Zhang, K, Wang, X, Gao, C, Yang, L, Li, K, Shi, S, Wang, G, Liu, L, Zhang, J, Du, B, Jiang, G, Shen, J, Zhang, Z, Liang, W, Sun, J, Hu, J, Liu, T, Miao, G, Meng, H, Hu, C, Huang, G, Li, G, Ha, B, Deng, H, Mei, Q, Zhong, H, Gao, S, Sang, H, Fang, X, Yu, F, Yang, D, Chen, Y, Hong, X, Wu, W, Chen, G, Cai, M, Song, Y, Pan, J, Dong, J, Pan, R, Zhang, W, Shen, Z, Liu, Z, Gu, D, Liu, X, Zhang, Q, Kendler, K
Format: Journal article
Language:English
Published: Public Library of Science 2014
_version_ 1797059405013843968
author Shi, J
Zhang, Y
Liu, F
Li, Y
Wang, J
Flint, J
Gao, J
Li, Y
Tao, M
Zhang, K
Wang, X
Gao, C
Yang, L
Li, K
Shi, S
Wang, G
Liu, L
Zhang, J
Du, B
Jiang, G
Shen, J
Zhang, Z
Liang, W
Sun, J
Hu, J
Liu, T
Wang, X
Miao, G
Meng, H
Li, Y
Hu, C
Li, Y
Huang, G
Li, G
Ha, B
Deng, H
Mei, Q
Zhong, H
Gao, S
Sang, H
Zhang, Y
Fang, X
Yu, F
Yang, D
Liu, T
Chen, Y
Hong, X
Wu, W
Chen, G
Cai, M
Song, Y
Pan, J
Dong, J
Pan, R
Zhang, W
Shen, Z
Liu, Z
Gu, D
Wang, X
Liu, X
Zhang, Q
Li, Y
Chen, Y
Kendler, K
author_facet Shi, J
Zhang, Y
Liu, F
Li, Y
Wang, J
Flint, J
Gao, J
Li, Y
Tao, M
Zhang, K
Wang, X
Gao, C
Yang, L
Li, K
Shi, S
Wang, G
Liu, L
Zhang, J
Du, B
Jiang, G
Shen, J
Zhang, Z
Liang, W
Sun, J
Hu, J
Liu, T
Wang, X
Miao, G
Meng, H
Li, Y
Hu, C
Li, Y
Huang, G
Li, G
Ha, B
Deng, H
Mei, Q
Zhong, H
Gao, S
Sang, H
Zhang, Y
Fang, X
Yu, F
Yang, D
Liu, T
Chen, Y
Hong, X
Wu, W
Chen, G
Cai, M
Song, Y
Pan, J
Dong, J
Pan, R
Zhang, W
Shen, Z
Liu, Z
Gu, D
Wang, X
Liu, X
Zhang, Q
Li, Y
Chen, Y
Kendler, K
author_sort Shi, J
collection OXFORD
description Background The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years. Principal findings We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders. Conclusions In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype.
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spelling oxford-uuid:283a6458-2ca7-4142-a2ab-310d5a30ad402022-03-26T12:11:44ZAssociations of educational attainment, occupation, social class and major depressive disorder among Han Chinese womenJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:283a6458-2ca7-4142-a2ab-310d5a30ad40EnglishSymplectic Elements at OxfordPublic Library of Science2014Shi, JZhang, YLiu, FLi, YWang, JFlint, JGao, JLi, YTao, MZhang, KWang, XGao, CYang, LLi, KShi, SWang, GLiu, LZhang, JDu, BJiang, GShen, JZhang, ZLiang, WSun, JHu, JLiu, TWang, XMiao, GMeng, HLi, YHu, CLi, YHuang, GLi, GHa, BDeng, HMei, QZhong, HGao, SSang, HZhang, YFang, XYu, FYang, DLiu, TChen, YHong, XWu, WChen, GCai, MSong, YPan, JDong, JPan, RZhang, WShen, ZLiu, ZGu, DWang, XLiu, XZhang, QLi, YChen, YKendler, KBackground The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years. Principal findings We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders. Conclusions In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype.
spellingShingle Shi, J
Zhang, Y
Liu, F
Li, Y
Wang, J
Flint, J
Gao, J
Li, Y
Tao, M
Zhang, K
Wang, X
Gao, C
Yang, L
Li, K
Shi, S
Wang, G
Liu, L
Zhang, J
Du, B
Jiang, G
Shen, J
Zhang, Z
Liang, W
Sun, J
Hu, J
Liu, T
Wang, X
Miao, G
Meng, H
Li, Y
Hu, C
Li, Y
Huang, G
Li, G
Ha, B
Deng, H
Mei, Q
Zhong, H
Gao, S
Sang, H
Zhang, Y
Fang, X
Yu, F
Yang, D
Liu, T
Chen, Y
Hong, X
Wu, W
Chen, G
Cai, M
Song, Y
Pan, J
Dong, J
Pan, R
Zhang, W
Shen, Z
Liu, Z
Gu, D
Wang, X
Liu, X
Zhang, Q
Li, Y
Chen, Y
Kendler, K
Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title_full Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title_fullStr Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title_full_unstemmed Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title_short Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women
title_sort associations of educational attainment occupation social class and major depressive disorder among han chinese women
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