Title
How sex differences in schooling and income contribute to sex differences in depression, anxiety and common mental disorders: The mental health sex-gap in a birth cohort from Brazil
Date Issued
01 September 2020
Access level
metadata only access
Resource Type
journal article
Author(s)
Carpena M.X.
Gonçalves H.
Quevedo L.d.A.
Pinheiro R.
dos Santos Motta J.V.
Horta B.
Federal University of Pelotas
Publisher(s)
Elsevier B.V.
Abstract
Background: Reasons for the higher rates of depression, anxiety and common mental disorders among women are unclear. We investigated the mediating effect of schooling and personal income and the effect modification of maternal schooling and family income at baseline. Methods: In 1982, the maternity hospitals of Pelotas (Southern Brazil) were daily visits and those livebirths whose family lived in the urban area of the city were examined and their mothers interviewed. At 30 years, the presence of major depression (MD) and generalized anxiety disorder (GAD) was assessed using the Mini-International Psychiatric Interview, and common mental disorders (CMD) with the self-rated questionnaire. We used Mantel-Haenszel test to assess effect modification and a counterfactual framework using inverse probability weights (IPW) and G-computation to analyze mediation. Results: Income at 30 years captured part of the association of sex with MD (16.5%), GAD (14.2%), and CMD (18.0%). Schooling at 30 years was higher in women (p<0.001), and therefore inversely mediated the association with MD (-5.4%), GAD (-4.8%), and CMD (-6.7%). If we fixed the mediator to earning more than 3 minimum salaries, the effect of sex, was reduced in 64.9%, 56.7% and 31.4%, for MD, GAD and CMD, respectively, and 62.4%, 13.6% and 23.8%, if fixed to 12 or more years of schooling. Limitations: We were not able to evaluate mental health and socioeconomic changes, or assess a bidirectional effect Conclusion: Personal income and schooling at 30 years, are important mediators and effect modifiers of the association between sex and MD, GAD, and CMD.
Start page
977
End page
985
Volume
274
Language
English
OCDE Knowledge area
Ciencias socio biomédicas (planificación familiar, salud sexual, efectos políticos y sociales de la investigación biomédica)
Psiquiatría
Subjects
Scopus EID
2-s2.0-85086167208
PubMed ID
Source
Journal of Affective Disorders
ISSN of the container
01650327
Sponsor(s)
We would like to acknowledge the contribution of all who participate in the 1982 Pelotas birth cohort. At the time this manuscript was written Marina Xavier Carpena was receiving a scholarship from the “Conselho Nacional de Desenvolvimento Científico e Tecnológico” (CNPq)”
The 1982 Pelotas birth cohort have had different sources of funding thru the years. The last follow up at 30 years was mainly funded by Wellcome Trust (UK) . However, other entities also collaborated in the follow-ups: “Coordenação de Aperfeiçoamento de Pessoal de Nível Superior” (CAPES), “Conselho Nacional de Desenvolvimento Científico e Tecnológico” (CNPq),” Associação Brasileira de Saúde Coletiva” (ABRASCO), “Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul” (FAPERGS), Ministry of Health (Brazil), European Union, National Program for Centers of Excellence - PRONEX (Brazil). None of the funding's sources had any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Sources of information:
Directorio de Producción Científica
Scopus