Crick Lund1, Annibale Cois2. 1. Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom. Electronic address: crick.lund@uct.ac.za. 2. Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, South Africa.
Abstract
BACKGROUND: Two theories have been proposed to explain the observed association between depression and poverty, namely social causation and social drift. Little is known regarding the relative importance of social causation and social drift in low and middle-income countries, where poverty is more severe and where most of the world's depressed individuals live. METHODS: We analysed nationally representative longitudinal data from the National Income Dynamics Study in South Africa and simultaneously tested social causation and social drift hypotheses using structural equation modelling across three waves. RESULTS: Worse individual economic status at time 1 and 2 was independently associated with worse depression two years later at time 2 (standardised linear regression coefficient β = -0.110, Standard Error (SE): 0.024) and four years later at time 3 (β = -0.113, SE: 0.025) respectively. Conversely worse depression at time 1 and time 2 was independently associated with worse economic status at time 2 (β = -0.037, SE: 0.016) and time 3 (β = -0.028, SE: 0.012) respectively. In addition, the "effect" of depression on future assets was stronger among people with less baseline assets. LIMITATIONS: The time span between data rounds is relatively short (four years); response rates are unequal across ethnic, age and sex groups; and the measure of depression is based on self-report. CONCLUSIONS: Social causation and social drift act simultaneously in this population, reinforcing poverty/depression cycles. Multi-sectoral policies are required that both prevent depression by addressing its economic determinants, and provide evidence-based treatment to mitigate the economic impact of depression.
BACKGROUND: Two theories have been proposed to explain the observed association between depression and poverty, namely social causation and social drift. Little is known regarding the relative importance of social causation and social drift in low and middle-income countries, where poverty is more severe and where most of the world's depressed individuals live. METHODS: We analysed nationally representative longitudinal data from the National Income Dynamics Study in South Africa and simultaneously tested social causation and social drift hypotheses using structural equation modelling across three waves. RESULTS: Worse individual economic status at time 1 and 2 was independently associated with worse depression two years later at time 2 (standardised linear regression coefficient β = -0.110, Standard Error (SE): 0.024) and four years later at time 3 (β = -0.113, SE: 0.025) respectively. Conversely worse depression at time 1 and time 2 was independently associated with worse economic status at time 2 (β = -0.037, SE: 0.016) and time 3 (β = -0.028, SE: 0.012) respectively. In addition, the "effect" of depression on future assets was stronger among people with less baseline assets. LIMITATIONS: The time span between data rounds is relatively short (four years); response rates are unequal across ethnic, age and sex groups; and the measure of depression is based on self-report. CONCLUSIONS: Social causation and social drift act simultaneously in this population, reinforcing poverty/depression cycles. Multi-sectoral policies are required that both prevent depression by addressing its economic determinants, and provide evidence-based treatment to mitigate the economic impact of depression.
Authors: Anita Robitzsch; Adam Schweda; Madeleine Hetkamp; Marco Niedergethmann; Nora Dörrie; Stephan Herpertz; Till Hasenberg; Sefik Tagay; Martin Teufel; Eva-Maria Skoda Journal: Front Psychiatry Date: 2020-07-10 Impact factor: 4.157