Social differences in diagnosed depression among adolescents in a Swedish population based cohort

Therese Wirback,Karin Engström,Jan-Olov Larsson,Jette Möller

doi:10.1186/s12888-018-1765-0

Abstract

BackgroundPopulation based research regarding social differences in diagnosed depression in adolescence is sparse. In this study unique material containing in-and outpatient data was used to determine if low social position in childhood increases the risk of diagnosed depression in adolescence. To further examine this association, gender differences and interactions were explored.MethodsThe study population was extracted from the Stockholm Youth Cohort (SYC), a register based cohort containing psychiatric care for all young people in Stockholm County and information about social position. For the purpose of this study, all in the SYC who turned 13 years old during 2001–2007, in total 169,262 adolescents, were followed up in 2005–2011 for diagnoses of depression until age 18. Associations were estimated with Cox regression models and presented as Hazard Ratios (HR).ResultsThe risk of diagnosed depression was higher for adolescents with parents with low education (HR = 1.1, CI = 1.0–1.2) and medium education (HR = 1.1, CI = 1.1–1.2) compared to high as well as for those with lower household income (for example, medium low, HR = 1.2, CI = 1.1–1.3) and for those with parents who received an unemployment benefit (HR = 1.3, CI = 1.2–1.4). No differences were found for those with the lowest household income compared to those with the highest level. Adolescents with parents born outside the Nordic countries had a lower risk of diagnosed depression (HR = 0.7, CI = 0.6–0.7). An interaction effect was found between gender and parental education.ConclusionsSocial differences were found but the magnitude was modest and gender differences small.

Highlights

Population based research regarding social differences in diagnosed depression in adolescence is sparse
One study looked at gender differences in relation to social position and diagnosed depression [27], and they found merely small differences
The aim was to determine if low social position in childhood increases the risk of diagnosed depression in adolescence (13–17 year olds), and if there are gender-specific differences

Summary

Methods

Setting and material The material derives from Sweden, a country with a relatively strong redistributive system with mental health services for adolescents primarily financed by tax. SYC includes all individuals aged 0–17 residing in Stockholm County at any point in time during 2001 and 2011, ascertained from the Swedish register of the total population [35]. Study population and design The study population was extracted from SYC and is defined as adolescents who were residing in Stockholm County the year they turned 13, between 2001 and 2007, i.e. 7 consecutive birth cohorts (born 1988–1994). Parental depression was defined as occurring if a parent received a diagnosis in in-or outpatient care according to the following diagnoses from ICD 8, 9 and 10; F32.0–9, F33.0–9, F34.1,8,9, F38.0,1,8, F39, 300E, 296B, 311, 300, 296, 301.10, 302.99, 314.99. For this purpose the following variables were dichotomized: parental education (low/medium vs high), household income (low/medium low/ medium vs medium high/high) and parental country of birth (born in Sweden or not).

Results

Background

Discussion

Strengths and limitations