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Status inconsistency and common mental disorders in the Israel-based world mental health survey

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Abstract

Objective

Research on status inconsistency (SI) and its impact on mental health has been dormant for many years. This study tested the association between SI and emotional distress, anxiety and mood disorders.

Methods

Data were gathered from the Israel-based component of the World Mental Health Survey (n = 4,859). SI was defined by the combination of high education (13+ years) with low income (1st decile). Mood and anxiety disorders were diagnosed with the composite international diagnostic instrument (CIDI), and emotional distress was measured with the 12-item general health questionnaire (GHQ-12).

Results

Multivariate analysis showed increased risk for mood or anxiety disorders among SI subjects (n = 231), odds ratio (OR) = 1.75, 95% confidence interval (95% CI) 1.13–2.63. The estimate was slightly attenuated when marital status was added to the model (OR = 1.55, 95% CI 1.0–2.39). SI subjects showed higher GHQ-12 scores.

Conclusion

SI, which can disrupt an individual’s sense of coherence, is associated, although not causally, with increased 12 month prevalence rates for mood or anxiety disorders and with higher psychological distress.

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Acknowldgments

The national health survey was funded by the Ministry of Health with additional support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The views and opinions expressed in this article are those of the authors and they neither represent the views of the sponsoring organizations nor of the Government. The Israel Health Survey was carried out in conjunction with the World Health Organization/World Mental Health (WMH) Survey Initiative. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centers for assistance with instrumentation, fieldwork and consultation on data analysis. These activities were supported by the National Institute of Mental Health (R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization/World Health Organization, Eli Lilly and Co., Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/.

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Authors and Affiliations

  1. Mental Health Epidemiology and Psychosocial Aspects of Illness, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel

    Gilad Gal, Giora Kaplan & Raz Gross

  2. Mental Health Services, Ministry of Health, Jerusalem, Israel

    Itzhak Levav

Authors
  1. Gilad Gal
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  2. Giora Kaplan
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  3. Raz Gross
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  4. Itzhak Levav
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Correspondence to Gilad Gal.

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Gal, G., Kaplan, G., Gross, R. et al. Status inconsistency and common mental disorders in the Israel-based world mental health survey. Soc Psychiat Epidemiol 43, 999–1003 (2008). https://doi.org/10.1007/s00127-008-0393-2

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  • DOI: https://doi.org/10.1007/s00127-008-0393-2

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