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Science 21 February 1992:
Vol. 255. no. 5047, pp. 946 - 952
DOI: 10.1126/science.1546291

Articles

Science, Vol 255, Issue 5047, 946-952
Copyright © 1992 by American Association for the Advancement of Science


articles

Socioeconomic status and psychiatric disorders: the causation-selection issue

BP Dohrenwend, I Levav, PE Shrout, S Schwartz, G Naveh, BG Link, AE Skodol, and A Stueve

New York State Psychiatric Institute, NY.

Are inverse relations between psychiatric disorders and socioeconomic status due more to social causation (adversity and stress) or social selection (downward mobility of genetically predisposed)? This classical epidemiological issue is tested by focusing on ethnic status in relation to socioeconomic status. Ethnic status cannot be an effect of disorder because it is present at birth whereas socioeconomic status depends on educational and occupational attainment. A birth cohort sample of 4914 young, Israel-born adults of European and North African background was selected from the country's population register, screened, and diagnosed by psychiatrists. Results indicate that social selection may be more important for schizophrenia and that social causation may be more important for depression in women and for antisocial personality and substance use disorders in men.


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