Childhood socioeconomic status and depression in adulthood: systematic review

Abstract

Abstract Background Low socioeconomic status (SES) is generally associated with poorer mental health, particularly depression. We carried out a systematic review to address the question of whether childhood SES is associated with depression in adulthood and the potential pathways which may explain this association. Methods We followed a systematic search strategy in PubMed and Scopus with specific inclusion and exclusion criteria. After removing duplicates, studies were screened for eligibility and quality was assessed independently by two assessors using the Newcastle-Ottawa scale. Results After the selection process, 20 observational studies (7 cohort and 13 cross-sectional) that examine the association between SES during childhood and depression in adulthood were included in the systematic review. The most common measures of childhood SES were parental education, occupation or family income, estimated subjectively and/or objectively. In 17 of the studies an inverse relationship between childhood SES and depression was shown. In 17 studies, models were employed to demonstrate the possible pathways which explain the relationship between childhood SES and depressive symptoms. The most important mediators were adult SES, psychosocial factors, childhood trauma and physical health. Conclusions Our findings reveal the long-term association between childhood socioeconomic conditions and depression later in life. Suboptimal childhood SES seems to be an important risk factor for depression in adulthood. Improving childhood socioeconomic conditions can potentially have lasting effects well beyond childhood. Key messages • Protecting children against the effects of socioeconomic adversity could reduce depression in adult life. • Policy makers should direct resources towards alleviating childhood disadvantage for promoting health in adulthood.