Skip to main content
×
Home
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 11
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    DALY, MICHAEL 2012. Letter to the Editor: The midlife peak in distress amongst the disadvantaged and existing ideas about mental health inequalities over the lifespan. Psychological Medicine, Vol. 42, Issue. 01, p. 215.


    Bell, Andrew 2014. Life-course and cohort trajectories of mental health in the UK, 1991–2008 – A multilevel age–period–cohort analysis. Social Science & Medicine, Vol. 120, p. 21.


    Buchanan, Robert J. and Huang, Chunfeng 2013. The Need for Mental Health Care Among Informal Caregivers Assisting People with Multiple Sclerosis. International Journal of MS Care, Vol. 15, Issue. 2, p. 56.


    Martin-Carrasco, M. Evans-Lacko, S. Dom, G. Christodoulou, N. G. Samochowiec, J. González-Fraile, E. Bienkowski, P. Gómez-Beneyto, M. Dos Santos, M. J. H. and Wasserman, D. 2016. EPA guidance on mental health and economic crises in Europe. European Archives of Psychiatry and Clinical Neuroscience, Vol. 266, Issue. 2, p. 89.


    Weiss, A. King, J. E. Inoue-Murayama, M. Matsuzawa, T. and Oswald, A. J. 2012. Evidence for a midlife crisis in great apes consistent with the U-shape in human well-being. Proceedings of the National Academy of Sciences, Vol. 109, Issue. 49, p. 19949.


    Schmidt, Sören Petermann, Franz and Brähler, Elmar 2012. Soziale Ungleichheit, psychische und körperliche Gesundheit – welchen Einfluss hat das Alter?. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, Vol. 60, Issue. 3, p. 205.


    Jeste, Dilip V. and Oswald, Andrew J. 2014. Individual and Societal Wisdom: Explaining the Paradox of Human Aging and High Well-Being. Psychiatry: Interpersonal and Biological Processes, p. 1.


    Hubbard, Ruth E Peel, Nancye M Samanta, Mayukh Gray, Leonard C Fries, Brant E Mitnitski, Arnold and Rockwood, Kenneth 2015. Derivation of a frailty index from the interRAI acute care instrument. BMC Geriatrics, Vol. 15, Issue. 1,


    Cheng, Terence C. Powdthavee, Nattavudh and Oswald, Andrew J. 2015. Longitudinal Evidence for a Midlife Nadir in Human Well-being: Results from Four Data Sets. The Economic Journal, p. n/a.


    Blay, Sergio L. Fillenbaum, Gerda G. and Peluso, Erica T. 2015. Differential characteristics of young and midlife adult users of psychotherapy, psychotropic medications, or both: information from a population representative sample in São Paulo, Brazil. BMC Psychiatry, Vol. 15, Issue. 1,


    Jeste, Dilip V. and Oswald, Andrew J. 2014. Individual and Societal Wisdom: Explaining the Paradox of Human Aging and High Well-Being. Psychiatry: Interpersonal and Biological Processes, Vol. 77, Issue. 4, p. 317.


    ×

Income and the midlife peak in common mental disorder prevalence

  • I. A. Lang (a1) (a2), D. J. Llewellyn (a3), R. E. Hubbard (a4), K. M. Langa (a5) (a6) (a7) and D. Melzer (a3)
  • DOI: http://dx.doi.org/10.1017/S0033291710002060
  • Published online: 10 December 2010
Abstract
Background

The prevalence of psychological distress and common mental disorders has been shown to peak in midlife but analyses have ignored the association of poor material circumstances with prevalence. This study aimed to test the hypothesis that the midlife prevalence peak occurs only in lower-income households.

Method

Pooled data were used from the annual Health Survey for England, a nationally representative cross-sectional study, on community-dwelling individuals aged ⩾16 years from years 1997 to 2006 (n=100 457). 12-item General Health Questionnaire scores, reported mental illness diagnoses and receipt of relevant medication were assessed in relation to household income and age. Analyses were separated by gender and adjusted for age, ethnicity, smoking, social class, education and co-morbidities.

Results

Prevalence of psychological distress, diagnoses and treatments rose with age until early middle age and declined subsequently. In analyses conducted separately by income categories, this pattern was marked in low-income groups but absent in high-income groups. Income-related inequalities in the prevalence of psychological distress were greatest in midlife; for example, in men aged 45–54 years the odds ratio of receiving psychiatric medication in the lowest income group compared with the highest was 7.50 [95% confidence interval (CI) 4.24–13.27] and in women aged 45–54 years the odds ratio of reporting mental illness was 10.25 (95% CI 6.16–17.05).

Conclusions

An increased prevalence of psychological distress, common mental disorder diagnoses and treatment in midlife is not a universal phenomenon but is found only in those in low-income households. This implies the phenomenon is not inevitable but is potentially manageable or preventable.

Copyright
Corresponding author
*Address for correspondence: Dr I. A. Lang, PenCLAHRC, Peninsula Medical School, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK. (Email: iain.lang@pms.ac.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

F Barbone , AD McMahon , PG Davey , AD Morris , IC Reid , DG McDevitt , TM MacDonald (1998). Association of road-traffic accidents with benzodiazepine use. Lancet 352(9137), 13311336.

JC Barefoot , M Schroll (1996). Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation 93, 19761980.

AW Bergen , N Caporaso (1999). Cigarette smoking. Journal of the National Cancer Institute 91, 13651375.

DG Blanchflower , AJ Oswald (2008). Is well-being U-shaped over the life cycle? Social Science & Medicine 66, 17331749.

H Brockman (2010). Why are middle-aged people so depressed? Evidence from West Germany. Social Indicators Research 97, 2342.

LL Carstensen , DM Isaacowitz , S Turk-Charles (1999). Taking time seriously: a theory of socioeconomic selectivity. American Psychologist 54, 165181.

ST Charles , CA Reynolds , M Gatz (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology 80, 136151.

M Cropley , A Steptoe , K Joekes (1999). Job strain and psychiatric morbidity. Psychological Medicine 29, 14111416.

B Dickey , SLT Normand , RD Weiss , RE Drake , H Azeni (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services 53, 861867.

D Dooley , J Fielding , L Levi (1996). Health and unemployment. Annual Review of Public Health 17, 449465.

JE Ferrie , MJ Shipley , MG Marmot , S Stansfeld , GD Smith (1998). The health effects of major organisational change and job insecurity. Social Science and Medicine 46, 243254.

T Fryers , D Melzer , R Jenkins (2003). Social inequalities and the common mental disorders – a systematic review of the evidence. Social Psychiatry and Psychiatric Epidemiology 38, 229237.

JJ Gallo , DR Royall , JC Anthony (1993). Risk factors for the onset of depression in middle age and later life. Social Psychiatry and Psychiatric Epidemiology 28, 101108.

ME Jackson-Triche , J Greer Sullivan , KB Wells , W Rogers , P Camp , R Mazel (2000). Depression and health-related quality of life in ethnic minorities seeking care in general medical settings. Journal of Affective Disorders 58, 8997.

R Jenkins , G Lewis , P Bebbington , T Brugha , M Farrell , B Gill , H Meltzer (1997). The National Psychiatric Morbidity Surveys of Great Britain – initial findings from the Household Survey. Psychological Medicine 27, 775789.


I Kawachi , D Sparrow , PS Vokonas , ST Weiss (1994). Symptoms of anxiety and risk of coronary heart disease: the Normative Aging Study. Circulation 90, 22252229.

CLM Keyes , CD Ryff (1999). Psychological well-being in midlife. In Life in the Middle: Psychological and Social Development in Middle Age (ed. S. L. Willis and J. D. Reid ), pp. 161178. Academic Press: San Diego.

E Laaksonen , P Martikainen , E Lahelma , T Lallukka , O Rahkonen , J Head , M Marmot (2007). Socioeconomic circumstances and common mental disorders among Finnish and British public sector employees: evidence from the Helsinki Health Study and the Whitehall II Study. International Journal of Epidemiology 36, 776786.

ME Lachman , C Lewkowicz , A Marcus , Y Ping (1994). Images of midlife development among young, middle-aged, and older adults. Journal of Adult Development 1, 201211.

E Lahelma , M Laaksonen , P Martikainen , O Rahkonen , L Sarlio (2006). Multiple measures of socioeconomic circumstances and common mental disorders. Social Science and Medicine 63, 13831399.

K Lasser , JW Boyd , S Woolhandler , DU Himmelstein , D McCormick , DH Bor (2000). Smoking and mental illness: a population-based prevalence study. Journal of the American Medical Association 284, 26062610.

V Lorant , D Deliege , W Eaton , A Robert , P Philippot , M Ansseau (2003). Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 157, 98112.

JD McLeod , RC Kessler (1990). Socioeconomic status differences in vulnerability to undesirable life events. Journal of Health and Social Behavior 31, 162172.


MG Marmot , GD Smith , S Stansfeld , C Patel , F North , J Head , I White , E Brunner , A Feeney (1991). Health inequalities among British civil servants: the Whitehall II study. Lancet 337(8754), 13871393.

A Mykletun , O Bjerkeset , M Dewey , M Prince , S Overland , R Stewart (2007). Anxiety, depression, and cause-specific mortality: the HUNT study. Psychosomatic Medicine 69, 323331.

J Ormel , GIJM Kempen , DJH Deeg , EI Brilman , E van Sonderen , J Relyveld (1998). Functioning, well-being, and health perception in late middle-aged and older people: comparing the effects of depressive symptoms and chronic medical conditions. Journal of the American Geriatrics Society 46, 3948.

M Prince , V Patel , S Saxena , M Maj , J Maselko , MR Phillips , A Rahman (2007). No health without mental health. Lancet 370(9590), 859877.

MA Rapp , D Gerstorf , H Helmchen , J Smith (2008). Depression predicts mortality in the young old, but not in the oldest old: results from the Berlin Aging Study. American Journal of Geriatric Psychiatry 16, 844852.

NE Rice , IA Lang , W Henley , D Melzer (2010). Baby boomers nearing retirement: the healthiest generation? Rejuvenation Research 13, 105114.

J Snowdon (2001). Is depression more prevalent in old age? Australian and New Zealand Journal of Psychiatry 35, 782787.

CH van Gool , GIJM Kempen , BWJH Penninx , DJH Deeg , ATF Beekman , JTM van Eijk (2005). Impact of depression on disablement in late middle aged and older persons: Results from the Longitudinal Aging Study Amsterdam. Social Science and Medicine 60, 2536.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: