Inter-generational longitudinal study of social class and depression: a test of social causation and social selection models.

BACKGROUND: Generations of epidemiologists have documented an association between low socio-economic status (SES) and depression (variously defined), but debate continues as to which is the causative factor. AIMS: To test the extent to which social causation (low SES causing depression) and social selection (depression causing low SES) processes are in evidence in an inter-generational longitudinal study. METHOD: Participants (n = 756) were interviewed up to four times over 17 years using the Schedule for Affective Disorders and Schizophrenia (SADS). RESULTS: Low parental education was associated with increased risk for offspring depression, even after controlling for parental depression, offspring gender and offspring age. Neither parental nor offspring depression predicted later levels of offspring occupation, education or income. CONCLUSION: There is evidence for an effect of parental SES on offspring depression (social causation) but not for an effect of either parental or offspring depression on offspring SES (social selection).

A survey on issues in the lives of women with severe mental illness.

OBJECTIVE: Women with severe mental illness were surveyed to explore issues in living with mental illness, personal relationships, and professional relationships and health care. The topics were drawn from the literature on the psychology of women and from separate focus groups of therapists and mental health care consumers. The women's survey responses were compared with men's responses to an equivalent survey to determine if the issues affected women and men similarly. METHODS: A 76-item questionnaire was completed by 107 women and 59 men from ten rehabilitation centers in Maryland. RESULTS: A larger proportion of women than men cited personal relationships as their most important formative experiences, with only 32 percent of women citing severe mental illness or related issues as formative experiences. Despite acknowledging the negative impact of several mental illness on their lives, most respondents reported normal concerns rather than illness-related ones, and most were relatively satisfied with their lives. Respondents made sense of their problems in diverse ways, although most knew their diagnosis. Women reported both more and better quality personal relationships than men. However, women were more likely than men to report a history of sexual abuse. Women reported generally good relationships with providers. About one-quarter to one-third of women reported not receiving proper care for birth control and menopause and not receiving pelvic or breast examinations. CONCLUSIONS: The survey results suggested that personal relationships are central in women's lives, that women with severe mental illness do not see their mental illness as the main feature of their identities, and that women's experience of living with severe mental illness is considerably different from that of men.