Abstract
The association of socio-economic-demographic (SED; e.g., income-related) factors with depression is widely confirmed in the literature. We conducted a hospital-based case-control study of 160 patients with psychiatrist-diagnosed clinical depression. The control group comprised 160 participants recruited from local communities. We used a questionnaire to collect SED data from all participants. We replaced missing values using multiple imputation analyses and further analyzed the pooled data of five imputations. We also recorded the results from the original analysis and each imputation. Univariate analyses showed income was associated with depression. Multiple logistic regression analyses revealed that, among all SED variables, high income (odds ratio = 2.088 [95% confidence interval = 1.178-3.700]; p = 0.012), middle-level (completed junior or senior high school) education (1.688 [1.042-2.734]; p = 0.033) and cohabitating with four or more family members (1.632 [1.025-2.597]; p = 0.039) were significant predictors for the case group. We conclude that cash income is a determinant of depression in hospital outpatients in Indonesia. This study suggests health policy implications toward better hospital access and service for people with depression in middle- or low-income households, and recommends considering high income as correlated with a high risk of depression, owing to socio-cultural changes.
Highlights
Investigation of the association between socio-economic status (SES) and mental disorders has been a research focus since the 1930s [1,2,3,4,5,6]
The ethnic composition differed between the groups especially in that the case group had fewer people of mixed ethnicity and more “others.” Among the socio-economic characteristics, only the income level differed between the groups, showing more with “high” income group and fewer with “middle” income for the case group
Income contributed to proportional reduction in error (PRE) for depression at 18.1%
Summary
Investigation of the association between socio-economic status (SES) and mental disorders has been a research focus since the 1930s [1,2,3,4,5,6]. Results have confirmed a relationship between SES and various mental disorders (e.g., depression) in Western societies, leading to hypotheses about “social stress” or “social causation” [7,8,9].
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