The Association Between Income and Distress, Mental Disorders, and Suicidal Ideation and Attempts: Findings From the Collaborative Psychiatric Epidemiology Surveys
J Clin Psychiatry 2010;71(9):1168-1175
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Objective: To examine the relationship between household income and psychological distress, suicidal ideation and attempts, and mood, anxiety, and substance use disorders.
Method: Data came from the Collaborative Psychiatric Epidemiology Surveys, a collection of 3 nationally representative surveys of American adults conducted between 2001 and 2003. Psychological distress, suicidal ideation, suicide attempts, and mood, anxiety, and substance use disorders were examined in relation to household income after adjusting for sex, marital status, race, age, and employment status.
Results: Analyses revealed an inverse association between income and psychological distress as measured by the Kessler Psychological Distress Scale, with those in the lowest income quartile demonstrating significantly more distress than any of the remaining 3 income quartiles (P < .05). Subsequent analysis of DSM-IV–diagnosed psychological disorders revealed a similar pattern of results, which were particularly strong for substance use disorders (adjusted odds ratio [AOR] = 1.74; 95% CI, 1.39–2.18), suicidal ideation (AOR = 1.77; 95% CI, 1.46–2.13), and suicide attempts (AOR = 2.15; 95% CI, 1.55–2.98). The association between income and mood and anxiety disorders was less consistent, and the relationship between income and suicidal ideation differed among the 5 race categories (non-Hispanic white, Hispanic, Asian American, black, and other). Non-Hispanic white persons showed a strong, negative relationship between income and suicidal ideation (AOR = 2.15; 95% CI, 1.66–2.80), while the association was considerably weaker or nonexistent for the other races.
Conclusions: Although conclusions cannot be drawn concerning causation, the strength of associations between income, suicidal ideation, suicide attempts, and substance abuse points to the need for secondary prevention strategies among low-income, high-risk populations.
J Clin Psychiatry
Submitted: December 23, 2008; accepted April 21, 2009.
Online ahead of print: April 6, 2010 (doi:10.4088/JCP.08m04986gry).
Corresponding author: Katherine A. McMillan, BA (Hons), University of Regina, Anxiety and Illness Behaviors Laboratory, 3737 Wascana Parkway, Regina, Saskatchewan, S4S 0A2, Canada (firstname.lastname@example.org).