Ageing, social class and common mental disorders: longitudinal evidence from three cohorts in the West of Scotland

Psychol Med. 2011 Mar;41(3):565-74. doi: 10.1017/S0033291710000851. Epub 2010 May 6.


Background: Understanding how common mental disorders such as anxiety and depression vary with socio-economic circumstances as people age can help to identify key intervention points. However, much research treats these conditions as a single disorder when they differ significantly in terms of their disease burden. This paper examines the socio-economic pattern of anxiety and depression separately and longitudinally to develop a better understanding of their disease burden for key social groups at different ages.

Method: The Twenty-07 Study has followed 4510 respondents from three cohorts in the West of Scotland for 20 years and 3846 respondents had valid data for these analyses. Hierarchical repeated-measures models were used to investigate the relationship between age, social class and the prevalence of anxiety and depression over time measured as scores of 8 or more out of 21 on the relevant subscale of the Hospital Anxiety and Depression Scale (HADS).

Results: Social class differences in anxiety and depression widened with age. For anxiety there was a nonlinear decrease in prevalence with age, decreasing more slowly for those from manual classes compared to non-manual, whereas for depression there was a non-linear increase in prevalence with age, increasing more quickly for those from manual classes compared to non-manual. This relationship is robust to cohort, period and attrition effects.

Conclusions: The more burdensome disorder of depression occurs more frequently at ages where socio-economic inequalities in mental health are greatest, representing a 'double jeopardy' for older people from a manual class.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aging / psychology*
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Confidence Intervals
  • Cost of Illness
  • Depression / epidemiology
  • Depression / etiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / etiology*
  • Middle Aged
  • Odds Ratio
  • Scotland / epidemiology
  • Sex Factors
  • Social Class*
  • Socioeconomic Factors
  • Young Adult