Abstract
BackgroundIn Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced. Therefore, the aim was to investigate whether multiple measures of low social status in childhood affect depressive symptoms in adolescence. A secondary aim was to explore potential gender effect modification.MethodsParticipants were recruited in 1998 for a longitudinal study named BROMS. The study population at baseline consisted of 3020 children, 11–12 years-old, from 118 schools in Stockholm County, followed up through adolescence. This study is based on 1880 adolescents answering the follow-up survey in 2004, at age 17–18 (62% of the initial cohort). Parental education, occupation, country of birth, employment status and living arrangements were reported at baseline, by parents and adolescents. Depressive symptoms were self-reported by the adolescents in 2004, using a 12-item inventory. The associations between childhood social status and depressive symptoms in adolescence are presented as Odds Ratios (OR), estimated through logistic regression. Gender interaction with social factors was estimated through Synergy Index (SI).ResultsIncreased risk of depressive symptoms was found among adolescents whose parents had low education (OR 1.8, CI = 1.1-3.1), were unskilled workers (OR 2.1, CI = 1.2-3.7), intermediate non-manual workers (OR 1.8, CI = 1.0-3.0), or self-employed (OR 2.2, CI = 1.2-3.7), compared to parents with high education and high non-manual work. In addition, adolescents living exclusively with one adult had an increased risk compared to those living with two (OR 2.8, CI = 1.1-7.5), while having foreign-born parents was not associated with depressive symptoms. An interaction effect was seen between gender and social factors, with an increased risk for girls of low-educated parents (SI = 3.4, CI = 1.3-8.9) or living exclusively with one adult (SI = 4.9, CI = 1.4-6.8).ConclusionsThe low social position in childhood may increase the risk of depressive symptoms among adolescents even in countries with small social differences and a highly developed welfare system, such as Sweden. Girls with low educated parents or living exclusively with one adult may be particularly vulnerable. This knowledge is of importance when planning preventive interventions or treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-014-0096-0) contains supplementary material, which is available to authorized users.
Highlights
In Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced
Social factors and depressive symptoms, Score 17 The prevalence of depressive symptoms measured as Score 17 was 11.2% (Figure 1)
Adolescents with parents with the lowest educational level were at increased risk of depressive symptoms (OR = 1.8, CI = 1.1-3.1) compared to those with highly educated parents
Summary
In Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced. The aim was to investigate whether multiple measures of low social status in childhood affect depressive symptoms in adolescence. In Sweden, self-reported depressive symptoms have increased among young people of both genders in the past two decades [1,11]. The prevalence of adolescents treated for depression has increased [12] This is especially worrisome given that depression in adolescence, including subclinical depression [13], is a risk factor for a clinical depression later in life [14] as well as for other types of mental illhealth [15], substance abuse [16], suicide [17] and low educational attainment and unemployment [9,15,17]. Exposure to disadvantageous social and material family conditions, such as low educational level, unemployment, lack of resources and lack of time, can be hypothesized both to increase mental distress among children and to decrease possibilities for parents to afford, demand and receive good health care for their children
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