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Socioeconomic disadvantage affects course and recurrence of psychiatric disability
  1. Stephen Stansfeld
  1. Correspondence to Professor Stephen Stansfeld, Centre for Psychiatry, Barts & the London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; s.a.stansfeld{at}qmul.ac.uk

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Virtanen et al's study1 in this issue of OEM (see page XXX) finds that being in a less advantaged socioeconomic position (SEP) in a cohort study of Finnish public sector workers is associated with an increased risk of the onset of disability for a range of psychiatric disorders including schizophrenia, depressive disorders, anxiety disorders, personality disorders and substance use disorders but not bipolar disorders and adjustment disorders. Less advantaged SEP was also associated with slower return to work, except for anxiety disorders, bipolar disorders and adjustment disorders. Of great importance is that less advantaged SEP also predicted a greater risk of recurrence of work disability. The large population studied, the good response rate and the excellent access to register data increase the reliability of the study findings. Unfortunately, the severity of the disorder, which predicts the duration of the episode, was not measured.2 Also, there must be some questions about the reliability of the psychiatric diagnoses in the register data assessed by multiple clinicians.

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