ISSN: 2167-1044
+44 1223 790975
Ahmed Yaogo, Jean-François Chastang, Marcel Goldberg, Marie Zins, Nadia Younèz and Maria Melchior
Objectives: We tested the hypothesis that depression course varies with individuals’ socioeconomic position, as measured by occupational grade.
Methods: Study participants (n=3,368) belong to the French GAZEL cohort study. Depressive symptoms were measured using the Center for Epidemiological Studies-Depression (CES-D) scale in 1996, 1999, 2002, 2005 and 2008. We studied the course of depressive symptoms in participants with a baseline CES-D score above a clinically significant cut-off in 1996. Socioeconomic position was measured by occupational grade. Analyses were controlled for demographic factors (sex and age), as well as covariates potentially associated with depression course which were measured both at study baseline and during follow-up: retirement status, social network, tobacco smoking, heavy alcohol use, body mass, prior depression, somatic chronic disease, life events and use of antidepressants. Data were analyzed in a repeated measures logistic regression framework (Generalized Estimating Equations, GEE).
Results: Compared with participants with high occupational grade, those with intermediate or low occupational grade were more likely to have persistent depression (respectively age and sex-adjusted ORs: intermediate occupational grade: 1.18, 95% CI 1.04-1.34; low occupational grade: 1.60, 95% CI 1.34-1.91). After adjusting for all covariates, associations between occupational grade and depression course decreased but remained statistically significant (fully adjusted ORs: intermediate occupational grade: 1.12, 95% CI 0.97-1.29; low occupational grade: 1.37, 95% CI 1.12-1.67).
Conclusions: Occupational grade predicts the course of depressive symptoms, which should be brought to the attention of policymakers and mental health specialists