Changes in socioeconomic position among individuals with mental disorders during the economic recession in Portugal: a follow-up of the National Mental Health Survey

Epidemiol Psychiatr Sci. 2019 Dec;28(6):638-643. doi: 10.1017/S2045796018000392. Epub 2018 Aug 6.


Aims: Portugal was one of the European countries most affected by the period of economic recession initiated in 2008. Social inequalities are likely to widen during such periods and disproportionately affect people with mental disorders. The present study aims to compare self-reported changes in indicators of socioeconomic position during the economic recession in Portugal among people with and without mental disorders in the beginning of this period. Three dimensions were assessed, namely employment situation, experiences of financial hardship and subjective social status.

Methods: Data from the World Mental Health Survey Initiative Portugal (2008/2009) and from the National Mental Health Survey Follow-up (2015/2016) were used (n = 911). Multinomial and logistic recession models were performed to examine the association between the presence of any 12-month mood or anxiety mental disorder in 2008/2009 and indicators of socioeconomic position in 2015/2016. All analyses were adjusted for gender, age, presence of any physical disorder and education at the baseline.

Results: Participants that had any mental disorder in the beginning of the economic recession reported 2.20 (95% CI 1.31-3.71; P < 0.01) higher odds of financial hardship related to daily life in 2015/2016, when compared with those without any mental disorder, after adjusting for age, gender, education and presence of any physical disorder. The results may also suggest a pattern of increased socioeconomic disadvantage among people with prior mental disorder, despite not reaching statistical significance.

Conclusions: The results of this study suggest that the economic recession may have contributed to wider social inequalities between people with and without mental disorders. Policies to support these individuals, such as access to treatment and alleviation of financial hardship, should be a priority in times of economic downturn.

Keywords: Common mental disorders; epidemiology; mental health; population survey; social factors.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Economic Recession / statistics & numerical data*
  • Employment / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / economics*
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • Portugal / epidemiology
  • Quality of Life / psychology
  • Socioeconomic Factors*
  • Surveys and Questionnaires