Status inconsistency and common mental disorders in the Israel-based world mental health survey

Objective  Research on status inconsistency (SI) and its impact on mental health has been dormant for many years. This study tested the association between SI and emotional distress, anxiety and mood disorders. Methods  Data were gathered from the Israel-based component of the World Mental Health Survey (n = 4,859). SI was defined by the combination of high education (13+ years) with low income (1st decile). Mood and anxiety disorders were diagnosed with the composite international diagnostic instrument (CIDI), and emotional distress was measured with the 12-item general health questionnaire (GHQ-12). Results  Multivariate analysis showed increased risk for mood or anxiety disorders among SI subjects (n = 231), odds ratio (OR) = 1.75, 95% confidence interval (95% CI) 1.13–2.63. The estimate was slightly attenuated when marital status was added to the model (OR = 1.55, 95% CI 1.0–2.39). SI subjects showed higher GHQ-12 scores. Conclusion  SI, which can disrupt an individual’s sense of coherence, is associated, although not causally, with increased 12 month prevalence rates for mood or anxiety disorders and with higher psychological distress.