Skip to main content

Advertisement

Log in

The Roles of Socioeconomic Status, Occupational Health and Job Rank on the Epidemiology of Different Psychiatric Symptoms in a Sample of UK Workers

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

There is a considerable gap in epidemiological literature about community mental health showing how psychiatric symptoms are associated with job rank, socioeconomic status, and occupational health. We examine data from 4596 employees collected in the United Kingdom’s Psychiatric Morbidity among Adults Living in Private Households Survey. There were 939 workers in managerial jobs, 739 in supervisory jobs and 2918 employees in lower ranking jobs. Of the 4596 workers, 2463 had depressive symptoms and 2133 no depressive symptoms. Job rank, household gross income, social class, personal gross income and socio-economic group were significantly associated with general health, occupational health and depressive and avoidant symptoms. Job rank, occupational and physical health also explained the variance in paranoid and avoidant symptoms among the employees. This study shows that severe psychopathology is related to workers’ job rank.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Khan, R. L., & Syme, S. L. (1994). Socio-economic status and health. The challenge of the gradient. American Psychologist, 49(1), 15–24.

    Article  CAS  Google Scholar 

  • American Psychiatric Association (APA) (1994) Diagnostic and statistic manual of mental disorders (DSM). Washington, D.C.: American Psychiatric Association Publications.

    Google Scholar 

  • Anderson, C., & Brown, C. E. (2010). The functions and dysfunctions of hierarchy. Research in Organizational Behavior, 30, 55–89.

    Article  Google Scholar 

  • Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (1992) The alcohol use disorders identification test (AUDIT) guidelines for use in primary care. Geneva: World Health Organization, Department of Mental Health and Substance Dependence.

    Google Scholar 

  • Bebbington, P., & Nayani, T. (1995). The Psychosis Screening Questionnaire. International Journal of Methods Psychiatric Research, 5, 11–19.

    Google Scholar 

  • Calixto, O. J., & Anaya, J. M. (2014). Socioeconomic status: The relationship with health and autoimmune diseases. Autoimmunity Reviews, 13(6), 641–654.

    Article  PubMed  Google Scholar 

  • Carroll, A. (2009). Are you looking at me? Understanding and managing paranoid personality disorder. Advances in Psychiatric Treatment, 15, 40–48.

    Article  Google Scholar 

  • Cheng, J. T., Tracy, J. L., & Henrich, J. (2010). Pride, personality, and the evolutionary foundations of human social status. Evolution and Human Behaviour, 31, 334–347.

    Article  Google Scholar 

  • Conway, D. L., Petticrew, M., Marlborough, H., Berthiller, J., Hashibe, M., & MacPherson, L. M. D. (2008). Socioeconomic inequalities and oral cancer risk: A systematic review and meta-analysis of case-control studies. International Journal of Cancer, 122, 2811–2819.

    Article  CAS  PubMed  Google Scholar 

  • Costa-Font, J., Hernández-Quevedo, C., & Jiménez-Rubio, D. (2014). Income inequalities in unhealthy life styles in England and Spain. Economics and Human Biology, 13, 66–75.

    Article  PubMed  Google Scholar 

  • Cottini, E. (2012). Health at work and low pay: A European perspective. The Manchester School, 80(1), 75–98.

    Article  Google Scholar 

  • de Graaf, R., Bijl, R. V., ten Have, M., et al. (2004). Pathways to comorbidity: The transition of pure mood, anxiety and substance use disorders into comorbid conditions in a longitudinal population-based study. Journal of Affective Disorders, 82, 461–467.

    Article  PubMed  Google Scholar 

  • Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M. (2008). Socioeconomic status and health: The role of subjective social status. Social Science and Medicine, 67(2), 330–340.

    Article  PubMed  Google Scholar 

  • Feinstein, J. S. (1993). The relationship between socioeconomic status and health: A review of the literature. The Milbank Quarterly, 71(2), 279–322.

    Article  CAS  PubMed  Google Scholar 

  • First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Structured clinical interview for DSM-IV axis II personality disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc.

    Google Scholar 

  • Fournier, J. C., DeRubeis, R. J., Amsterdam, J., Shelton, R. C., & Hollon, S. D. (2015). Gains in employment status following antidepressant medication or cognitive therapy for depression. British Journal of Psychiatry, 206, 332–338.

    Article  Google Scholar 

  • Freeman, D., Garety, P., Bebbington, P., Smith, B., Rollinson, R., & Fowler, D. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry, 16, 427–435.

    Article  Google Scholar 

  • Freeman, D., Garety, P., Kuipers, E., Fowler, D., & Bebbington, P. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41, 331–347.

    Article  Google Scholar 

  • Fujishiro, K., Xu, J., & Gong, F. (2010). What does "occupation" represent as an indicator of socioeconomic status?: Exploring occupational prestige and health. Social Science & Medicine, 71(12), 2100–2107. https://doi.org/10.1016/j.socscimed.2010.09.026.

    Article  Google Scholar 

  • Gilbert, P. (1992). Depression: The evolution of powerlessness. New York: Guilford Press.

    Google Scholar 

  • Gilbert, P. (1993). Defence and safety: Their function in social behaviour and psychopathology. British Journal of Clinical Psychology, 32, 131–153.

    Article  Google Scholar 

  • Gilbert, P. (2001). Evolutionary approaches to psychopathology: The role of natural defences. Australian & New Zealand Journal of Psychiatry, 35, 17–27.

    Article  CAS  Google Scholar 

  • Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relation of paranoid ideation and social anxiety in a mixed population. Clinical Psychology and Psychoterapy, 12, 124–133.

    Article  Google Scholar 

  • Gilbert, P., Gilbert, J., & Irons, C. (2004). Life events, entrapments and arrested anger in depression. Journal of Affective Disorders, 79, 149–160.

    Article  PubMed  Google Scholar 

  • Goldthorpe, J. H. (1997). The “Goldthorpe” class schema: Some observations on conceptual and operational issues in relation to the ESRC review of government social classifications. In D. Rose & K. O’Reilly (Eds.), Constructing classes. Swindon and London: ESRC and ONS.

    Google Scholar 

  • Harvey, S., Henderson, M., Lelliott, P., & Hotopf, M. (2009). Mental health and unemployment: Much work still to be done. The British Journal of Psychiatry, 194, 201–203. https://doi.org/10.1192/bjp.bp.108.055111.

    Article  PubMed  Google Scholar 

  • Health and Safety Executive (2016) Work-related stress, depression and anxiety statistics in the UK. National Statistics: http://www.hse.gov.uk/statistics/.

  • Jaspal, R., & Breakwell, G. M. (2014). Identity process theory: Identity, social action and social change. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Kamau, C. (2014). Outcomes of care programme approach, dual diagnosis, carer support and psychological therapy inductions. Psychiatric Bulletin, 38, 172–174.

    Article  Google Scholar 

  • Kamau, C. (2016). Is the NHS mental health service preparing clients to resume employment? Psychiatric Services, 67, 578–579.

    Article  PubMed  Google Scholar 

  • Kamau, C. (2017a). Postpartum depression or psychosis and return to work. Lancet Psychiatry, 4(2), 96–97.

    Article  PubMed  Google Scholar 

  • Kamau, C. (2017b). Preparing patients with cancer who work and treatment responsiveness. BMJ Supportive and Palliative Care, 7, 94–97.

    Article  PubMed  Google Scholar 

  • Kramer, R. M. (1994). The sinister attribution error: Paranoid cognition and collective distrust in organizations. Motivation and Emotion, 18, 199–230.

    Article  Google Scholar 

  • Kramer, R. M. (1999). Trust and distrust in organizations: Emerging perspectives, enduring questions. Annual Review of Psychology, 50, 569–598.

    Article  CAS  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lagerveld, S. E., Blonk, R. W., Brenninkmeijer, V., Wijngaards-de Meij, L., & Schaufeli, W. B. (2012). Work-focused treatment of common mental disorders and return to work: A comparative outcome study. Journal of Occupational Health Psychology, 17, 220–234.

    Article  PubMed  Google Scholar 

  • Lelliott, O., Tulloch, S., Boardman, J., et al. (2008). Mental health and work. Commissioned by the cross government health work and wellbeing programme. London: Royal College of Psychiatrists.

    Google Scholar 

  • Lerner, D., Adler, D., Chang, H., Lapitsky, L., Hood, M., Perissinotto, C., Reed, J., McLaughlin, T., Berndt, E., & Rogers, W. (2004). Unemployment, job retention, and productivity loss among employees with depression. Psychiatric Services, 55(12), 1371–1378. https://doi.org/10.1176/appi.ps.55.12.1371.

    Article  PubMed  Google Scholar 

  • Lewis G., & Pelosi A. J. (1990). The case-control study in psychiatry. British Journal of Psychiatry, 157, 197–207.

    Article  CAS  Google Scholar 

  • Lewis, G., Pelosi, A. J., Araya, R. C., & Dunn, G. (1992). Measuring psychiatric disorder in the community: A standardized assessment for use by lay-interviewers. Psychological Medicine, 22, 465–486.

    Article  CAS  PubMed  Google Scholar 

  • Lopes, B. (2013). Differences between victims of bullying and non-victims on levels of paranoid ideation and persecutory symptoms, the presence of aggressive traits, the display of social anxiety and the recall of childhood abuse experiences in a Portuguese mixed clinical sample. Clinical Psychology & Psychotherapy, 20(3), 254–266.

    Article  Google Scholar 

  • Lorant, V., Croux, C., Weich, S., Deliège, D., Mackenbach, J., & Ansseau, M. (2007). Depression and socio-economic risk factors: 7-Year longitudinal population study. The British Journal of Psychiatry, 190(4), 293–298.

    Article  PubMed  Google Scholar 

  • Lorant, V., Deliège, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157(2), 98–112.

    Article  CAS  PubMed  Google Scholar 

  • Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365, 1099–1104.

    Article  Google Scholar 

  • Marmot, M. G., Rose, G., Shipley, M., & Hamilton, P. J. (1978). Employment grade and coronary heart disease in British civil servants. Journal of Epidemiology and Community Health, 32(4), 244–249.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Marmot, M. G., & Smith, G. D. (1991). Health inequalities among British civil servants: The Whitehall II study. Lancet, 337(8754), 1387.

    Article  CAS  PubMed  Google Scholar 

  • McGee, R., & Thompson, N. (2015). Unemployment and depression among emerging adults in 12 states, behavioural risk surveillance system, 2010. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 12, 1–11.

    Article  Google Scholar 

  • Medisauskaite, A., & Kamau, C. (2017). Prevalence of oncologists in distress: Systematic review and meta-analysis. Psycho-Oncology, 26, 1732–1740.

    Article  PubMed  Google Scholar 

  • Morf, C., & Rhodewalt, F. (2001). Unraveling the paradoxes of narcissism: A dynamic self-regulatory model. Psychological Inquiry, 12, 177–196.

    Article  Google Scholar 

  • Office for National Statistics (2003) Psychiatric morbidity among adults living in private households, 2000 [computer file]. Colchester: UK Data Archive [distributor]. SN: 4653, https://doi.org/10.5255/UKDA-SN-4653-1.

  • Office of Population Censuses and Surveys (1990). Standard occupational classification (Vol. 1). HMSO: London.

    Google Scholar 

  • Rhode, P., Lewinsohn, P. M., & Seeley, J. (1991). Comorbidity of unipolar depression: II. Comorbidity With other mental disorders in adolescents and adults. Journal of Abnormal Psychology, 100(2), 214–222.

    Article  Google Scholar 

  • Schoenbaum, M., Unutzer, J., Sherbourne, C., et al. (2001). Cost-effectiveness of practice-initiated quality improvement for depression: Results of a randomized controlled trial. Journal of the American Medical Association, 286, 1325–1330.

    Article  CAS  PubMed  Google Scholar 

  • Schmueli, H., Rogowski, O., Toker, S., Melamed, S., Leshem-Rubinow, E., Ben-Assa, E., Shapira, I., Berliner, S., & Steinvil, A. (2014). Effect of socioeconomic status on cardio-respiratory fitness: Data from a health screening program. Journal of Cardiovascular Medicine, 15(6), 435–440.

    Article  PubMed  Google Scholar 

  • Simon, G. E., Revicki, D., Heiligenstein, J., et al. (2000). Recovery from depression, work productivity, and health care costs among primary care patients. General Hospital Psychiatry, 22, 153–162.

    Article  CAS  PubMed  Google Scholar 

  • Smith, A., Wadsworth, E., Moss, S., et al. (2004). The scale and impact of psychotropic medication use by workers. In Health and Safety Executive: Research Report 282. HSE Books: Crown Copyright.

    Google Scholar 

  • Stansfeld, S., Clark, C., Bebbington, P., King, M., Jenkins, R., & Hinchliffe, S. (2016). Chapter 2: Common mental disorders. In S. McManus, P. Bebbington, R. Jenkins & T. Brugha (Eds.), Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital.

    Google Scholar 

  • Stockwell, T., Murphy, D., & Hodgson, R. (1983) The severity of alcohol dependence questionnaire: Its use, reliability and validity. Addiction, 78(2), 145–155. https://doi.org/10.1111/j.1360-0443.1983.tb05502.x.

    Article  CAS  Google Scholar 

  • Ware, J., Kosinski, M., & Keller, S. D. (1996) A 12 item short form health survey: Construction of scales and preliminary tests of validity and reliability. Medical Care, 34(3), 220–233.

    Article  PubMed  Google Scholar 

  • Winkleby, M. A., Jatulis, D. E., Frank, E., & Fortmann, S. P. (1992). Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82(6), 816–820.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • World Health Organization (1993). The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. Geneva: WHO.

    Google Scholar 

  • Zhang, M., Rost, K. M., Fortney, J. C., et al. (1999). A community study of depression treatment and employment earnings. Psychiatric Services, 50, 1209–1213.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge that the UK Office for National Statistics is the copyright holder of the psychiatric morbidity survey dataset and was not involved in its interpretation for this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Lopes.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lopes, B., Kamau, C. & Jaspal, R. The Roles of Socioeconomic Status, Occupational Health and Job Rank on the Epidemiology of Different Psychiatric Symptoms in a Sample of UK Workers. Community Ment Health J 55, 336–349 (2019). https://doi.org/10.1007/s10597-018-0259-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-018-0259-3

Keywords

Navigation