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Social class and minor psychiatric disorder in British Civil Servants: a validated screening survey using the General Health Questionnaire

Published online by Cambridge University Press:  09 July 2009

S. A. Stansfeld  and
M. G. Marmot
S. A. Stansfeld*
Affiliation:
Academic Department of Psychiatry and Department of Community Medicine, University College and Middlesex Hospital School of Medicine, London
M. G. Marmot
Affiliation:
Academic Department of Psychiatry and Department of Community Medicine, University College and Middlesex Hospital School of Medicine, London
*
1 Address for correspondence: Dr S. A. Stansfeld, Academic Department of Psychiatry University College and Middlesex School of Medicine, Wolfson Building, Riding House Street, London W1N 8AA.
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Synopsis

Major psychiatric disorder is more common in people of lower rather than higher socioeconomic status. This is less clear for the commoner, so-called minor psychiatric disorders, but these are more affected by tendency to report symptoms. To examine this the distribution of minor psychiatric disorder by employment grade measured by the 30-item General Health Questionnaire is reported from the first cross-sectional phase of the Whitehall II Study of 10314 London-based civil servants, men and women between 35 and 55 years. Validation of the GHQ in a random subsample stratified by grade and sex (N = 201) suggested that people in lower employment grades tend to under-report minor psychiatric disorder on the GHQ relative to those in higher employment grades. The prevalence of minor psychiatric disorder corrected by the coefficients from the validity study was greater in the lower employment grades than the higher employment grades particularly for men. This was echoed in grade differences in well-being measured by the Affect Balance Scale, and in symptoms and recurrent health problems. Overall, for women there were few clear-cut differences in minor psychiatric disorder by employment grade. The lack of social class gradient in women suggests that further exploration should examine women's role at work and their personal lives for the aetiology of minor psychiatric disorder.

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 3 , August 1992 , pp. 739 - 749
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

BebbingtonP., Hurry, J. P., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981). Epidemiology of mental disorders in Camberwell. Psychological Medicine 11, 561–579.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.CrossRefGoogle ScholarPubMed
Bradburn, N. M. (1969). The Structure of Psychological Well-being. Aldine: Chicago.Google Scholar
Cochrane, R. & Stopes-Roe, M. (1980). Factors affecting the distribution of psychological symptoms in urban areas of England. Acta Psychiatrica Scandinavica 61, 445–460.Google Scholar
Cox, B., Blaxter, M., Buckle, A., Fenner, N. P., Golding, J., Gore, M., Huppert, F., Nickson, J., Rother, M., Stark, J., Wadsworth, M. & Wichelow, M. (1987). The Health and Lifestyle Survey. Health Promotion Trust: Cambridge.Google Scholar
D'Arcy, C. (1982). Prevalence and correlates of non-psychotic psychiatric symptoms in the general population. Canadian Journal of Psychiatry 27, 316–324.CrossRefGoogle Scholar
Diamond, E. L. & Lilienfield, A. M. (1962). Effects of errors in classification and diagnosis in various types of epidemiological studies. American Journal of Public Health 52, 1137–1144.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
Dohrenwend, B. P. & Dohrenwend, B. S. (1969). Social Status and Psychological Disorder: a Causal Inquiry. Wiley: New York.Google Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1974). Social and cultural influences on psychopathology. Annual Review of Psychology 25, 417–452.Google Scholar
Finlay-Jones, R. A. & Burvill, P. W. (1978). Contrasting demographic patterns of minor psychiatric morbidity in general practice and the community. Psychological Medicine 8, 455–466.CrossRefGoogle ScholarPubMed
Gerth, M. M. & Wright Mills, C. (1970). From Max Weber: Essays in Sociology. Routledge & Kegan Paul: London.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Maudsley Monograph No. 21. Oxford University Press: Oxford.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal ii, 439–443.CrossRefGoogle Scholar
Goldberg, D. P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire. NFER-Nelson: Windsor.Google Scholar
Hare, E. H. & Shaw, G. K. (1965). Mental Health on a New Housing Estate: A Comparative Study of Health in Two Districts in Croydon. Maudsley Monograph No. 12. Oxford University Press: London.Google Scholar
Hobbs, P. R., Ballinger, C. B., McClure, A., Martin, B. & Greenwood, C. (1985). Factors associated with psychiatric morbidity in men – a general practice survey. Acta Psychiatrica Scandinavica 71, 281–286.Google Scholar
Hodiamont, P., Peer, N. & Syben, N. (1987). Epidemiological aspects of psychiatric disorder in a Dutch Health Area. Psychological Medicine 17, 495–505.Google Scholar
Jenkins, R. (1985). Sex Differences In Minor Psychiatric Morbidity. Psychological Medicine Monograph Supplement 7. Cambridge University Press: Cambridge.Google Scholar
Lewis, G., Pelosi, A. J., Glover, E., Wilkinson, G., Stansfeld, S. A., Williams, P. & Shepherd, M. (1988). The development of a computerised assessment for minor psychiatric disorder. Psychological Medicine 18, 737–745.Google Scholar
Liberatos, P., Link, B. G. & Kelsey, J. L. (1988). The measurement of social class in epidemiology. Epidemiologic Reviews 10, 87–121.Google Scholar
Lin, T., Chu, H., Rin, H., Hsu, C., Yeh, E. & Chen, C. (1989). Effects of social change on mental disorder in Taiwan: observations based on a 15-year follow-up study of general populations in three communities. Acta Psychiatrica Scandinavica Supplement 348, 11–34.Google Scholar
Marmot, M. G., Shipley, M. J. & Rose, G. (1984). Inequalities in death – specific explanations of a general pattern. Lancet i, 1003–1006.Google Scholar
Marmot, M. G., Davey Smith, G., Stansfeld, S. A., Patel, C., North, F., Head, J., White, I., Brunner, E. & Feeney, A. (1991). Inequalities in health twenty years on: the Whitehall II Study of British civil servants. Lancet 337, 1387–1394.CrossRefGoogle Scholar
Metz, C. E., Wang, P. L. & Kronman, H. B. (1984). ROCFIT. Department of Radiology and the Franklin McLean Memorial Research Institute. University of Chicago.Google Scholar
Neugebauer, R., Dohrenwend, B. P. & Dohrenwend, B. S. (1980). Formulation of hypotheses about the true prevalence of functional psychiatric disorders among adults in the United States. In Mental Illness in the United States (ed. Dohrenwend, B. P., Dohrenwend, B. S., Schwartz-Gould, M., Link, B., Neugebauer, R. and Wunsch-Hitzig, R.), pp. 45–94. Praeger: New York.Google Scholar
OPCS (1979). General Household Survey for 1977. HMSO: London.Google Scholar
Rodgers, B. (1990). Adult affective disorder and early environment. British Journal of Psychiatry 157, 539–550.Google Scholar
Schepank, H. (1987). Epidemiology of Psychogenic Disorders. The Mannheim Study – Results of a Field Survey in the Federal Republic of Germany. Springer-Verlag: Berlin.Google Scholar
Sennett, R. & Cobb, J. (1972). The Hidden Injuries of Class. Knopf: New York.Google Scholar
Stansfeld, S. A. & Marmot, M. G. (1990). Life events, employment grade and wellbeing in British civil servants. Presented at International conference on Social Stress,Regents College,London,18–20 June, 1990.Google Scholar
Stansfeld, S. A., Gallacher, J. E. J., Sharp, D. S. & Yarnell, J. W. G. (1991). Social factors and minor psychiatric disorder in middle-aged men: a validation study and a population study. Psychological Medicine 21, 157–167.CrossRefGoogle Scholar
Surtees, P. G. (1987). The epidemiology of misfortune. In From Social Class to Social Stress (ed. Angermeyer, M. C.), pp. 282–301. Springer-Verlag: Berlin.Google Scholar
Taylor, Lord & Chave, S. (1964). Mental Health and Environment. Longman Green: London.Google Scholar
Vázquez-Barquero, J. L., Díez-Manrique, F. J., Peña, C., Aldama, J., Samaniego Rodrígues, C., Menéndez Arango, J. & Mirapeix, C. (1987). A community mental health survey in Cantabria: a general description of morbidity. Psychological Medicine 17, 227–241.Google Scholar
Weyerer, S., Dilling, H., Kohl, R. & Martens, H. (1982). Social class and mental disorders. A study of the use of medical services. Social Psychiatry 17, 133–141.Google Scholar
Williams, P., Tarnopolsky, A., Hand, D. & Shepherd, M. (1986). Minor Psychiatric Morbidity and General Practitioner Consultations: The West London Survey. Psychological Medicine Monograph Supplement 9. Cambridge University Press: Cambridge.Google Scholar