Educational attainment and anxiety in middle-aged and older Europeans.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 08 2023
16 08 2023
Historique:
received:
12
05
2023
accepted:
06
08
2023
medline:
18
8
2023
pubmed:
17
8
2023
entrez:
16
8
2023
Statut:
epublish
Résumé
We examined the relationship between educational attainment (EA) and anxiety symptoms in a sample of 77,792 individuals (median age = 64 years, 55% female) from the Survey of Health, Ageing and Retirement in Europe. Using logistic regression, we estimated odds ratio (OR) with 95% confidence interval (CI) for the association between EA (7 educational levels based on International Standard Classification of Education) and anxiety symptoms (12 or more points from the shortened 5-item version of the Beck Anxiety Inventory), adjusting for sociodemographic and health-related factors. We further explored whether the relationship varied by region, sex and age group. Independent of sociodemographic and health-related factors, higher levels of EA were associated with lower odds of anxiety symptoms. The magnitude of this association plateaued at first stage of tertiary education (OR 0.40; 95% CI 0.35-0.47, p < 0.001). The association was stronger in females, middle-aged individuals and in Central and Eastern Europe while not apparent in Northern Europe. Our findings suggest that individuals with higher education might be protected against anxiety throughout life. The protective effect of education against anxiety symptoms is more pronounced in less egalitarian regions and in females.
Identifiants
pubmed: 37587157
doi: 10.1038/s41598-023-40196-4
pii: 10.1038/s41598-023-40196-4
pmc: PMC10432412
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
13314Subventions
Organisme : NIA NIH HHS
ID : P01 AG005842
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG009740
Pays : United States
Organisme : NIA NIH HHS
ID : P01 AG008291
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG012815
Pays : United States
Organisme : NIA NIH HHS
ID : HHSN271201300071C
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG025169
Pays : United States
Informations de copyright
© 2023. Springer Nature Limited.
Références
Forlani, C. et al. Prevalence and gender differences in late-life depression: A population-based study. Am. J. Geriatr. Psychiatry 22, 370–380 (2014).
pubmed: 23567427
doi: 10.1016/j.jagp.2012.08.015
Wittchen, H. U. et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol. 21, 655–679 (2011).
pubmed: 21896369
doi: 10.1016/j.euroneuro.2011.07.018
Haro, J. M. et al. ROAMER: Roadmap for mental health research in Europe. Int. J. Methods Psychiatr. Res. 23, 1–14 (2014).
pubmed: 24375532
doi: 10.1002/mpr.1406
Miceli, M. & Castelfranchi, C. Expectancy and Emotion (OUP Oxford, 2014).
Kessler, R. C., Ruscio, A. M., Shear, K. & Wittchen, H. U. Epidemiology of anxiety disorders. Curr. Top. Behav. Neurosci. 2, (2010).
Blay, S. L. & Marinho, V. Anxiety disorders in old age. Current Opin. Psychiatry 25, 462–467 (2012).
doi: 10.1097/YCO.0b013e3283578cdd
Kessler, R. C. et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry Off. J. World Psychiatr. Assoc. WPA 6, 168 (2007).
Santini, Z. I. et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. Lancet Public Health 5, e62–e70 (2020).
pubmed: 31910981
doi: 10.1016/S2468-2667(19)30230-0
Yilmaz, A. & Dedeli, O. Keçiören Eğitim Araştirma Hastanesi, Turkey, & Celal Bayar University School of Health, Turkey. Assessment of anxiety, depression, loneliness and stigmatization in patients with tuberculosis. Acta Paul. Enferm. 29, 549–557 (2016).
doi: 10.1590/1982-0194201600076
Link, B. G. & Phelan, J. C. Stigma and its public health implications. The Lancet 367, 528–529 (2006).
doi: 10.1016/S0140-6736(06)68184-1
Hofmann, S. G. & Hinton, D. E. Cross-cultural aspects of anxiety disorders. Curr. Psychiatry Rep. 16, 450 (2014).
pubmed: 24744049
pmcid: 4037698
doi: 10.1007/s11920-014-0450-3
Bandelow, B. Epidemiology of anxiety disorders in the twenty-first century. Dialogues Clin. Neurosci. 17, 327–335 (2015).
pubmed: 26487813
pmcid: 4610617
doi: 10.31887/DCNS.2015.17.3/bbandelow
Beck, A. T., Epstein, N., Brown, G. & Steer, R. A. An inventory for measuring clinical anxiety: Psychometric properties. J. Consult. Clin. Psychol. 56, 893–897 (1988).
pubmed: 3204199
doi: 10.1037/0022-006X.56.6.893
Diagnostic and statistical manual of mental disorders (6th ed.). In (AmericanPsychiatricAssociation2022, 2022).
Miech, R. A. & Shanahan, M. J. Socioeconomic status and depression over the life course. J. Health Soc. Behav. 41, 162 (2000).
doi: 10.2307/2676303
Hummer, R. A. & Lariscy, J. T. Educational attainment and adult mortality. (2011). https://doi.org/10.1007/978-90-481-9996-9_12 .
Kunst, A. E. et al. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int. J. Epidemiol. 34, 295–305 (2005).
pubmed: 15563586
doi: 10.1093/ije/dyh342
Cutler, D. & Lleras-Muney, A. Education and Health: Evaluating Theories and Evidence (NBER Working Paper No. 12352). Natl. Bureu Econ. Res. (2006).
Mouw, T. et al. Education and risk of cancer in a large cohort of men and women in the United States. PLoS ONE 3, e3639 (2008).
pubmed: 18982064
pmcid: 2572908
doi: 10.1371/journal.pone.0003639
Bjelland, I. et al. Does a higher educational level protect against anxiety and depression? The HUNT Study. Soc. Sci. Med. 66, 1334–1345 (2008).
pubmed: 18234406
doi: 10.1016/j.socscimed.2007.12.019
Cutler, D. M., Huang, W. & Lleras-Muney, A. When does education matter? The protective effect of education for cohorts graduating in bad times. Soc. Sci. Med. 127, 63–73 (2015).
pubmed: 25113567
doi: 10.1016/j.socscimed.2014.07.056
Kuklová, M. et al. Educational inequalities in mental disorders in the Czech Republic: data from CZEch Mental health Study (CZEMS). Soc. Psychiatry Psychiatr. Epidemiol. 56, 867–877 (2021).
pubmed: 32789560
doi: 10.1007/s00127-020-01930-9
Mirowsky, J. & Ross, C. E. Education, Social Status, and Health (Transaction Publishers, 2003).
Chlapecka, A., Kagstrom, A. & Cermakova, P. Educational attainment inequalities in depressive symptoms in more than 100,000 individuals in Europe. Eur. Psychiatry 63, e97 (2020).
pubmed: 33190666
pmcid: 7737177
doi: 10.1192/j.eurpsy.2020.100
Wolbers, M. H. J. Job Mismatches and their labour-market effects among school-leavers in Europe. Eur. Sociol. Rev. 19, 249–266 (2003).
doi: 10.1093/esr/19.3.249
Bracke, P., Pattyn, E. & dem Knesebeck, O. V. Overeducation and depressive symptoms: Diminishing mental health returns to education. Sociol. Health Illn. 35, 1242–1259 (2013).
pubmed: 23909439
doi: 10.1111/1467-9566.12039
McLean, C. P., Asnaani, A., Litz, B. T. & Hofmann, S. G. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J. Psychiatr. Res. 45, 1027–1035 (2011).
pubmed: 21439576
pmcid: 3135672
doi: 10.1016/j.jpsychires.2011.03.006
Faravelli, C., Alessandra Scarpato, M., Castellini, G. & Lo Sauro, C. Gender differences in depression and anxiety: the role of age. Psychiatry Res. 210, 1301–1303 (2013).
pubmed: 24135551
doi: 10.1016/j.psychres.2013.09.027
Tetzner, J. & Schuth, M. Anxiety in late adulthood: Associations with gender, education, and physical and cognitive functioning. Psychol. Aging 31, 532 (2016).
pubmed: 27243761
doi: 10.1037/pag0000108
Permanyer, I. & Boertien, D. A century of change in global education variability and gender differences in education. PLoS ONE 14, e0212692 (2019).
pubmed: 30811455
pmcid: 6392467
doi: 10.1371/journal.pone.0212692
Ross, C. E. & Mirowsky, J. Sex differences in the effect of education on depression: Resource multiplication or resource substitution?. Soc. Sci. Med. 63, 1400–1413 (2006).
pubmed: 16644077
doi: 10.1016/j.socscimed.2006.03.013
Lleras-Muney, A. The relationship between education and adult mortality in the United States. Rev. Econ. Stud. 72, 189–221 (2005).
doi: 10.1111/0034-6527.00329
Albouy, V. & Lequien, L. Does compulsory education lower mortality?. J. Health Econ. 28, 155–168 (2009).
pubmed: 18976824
doi: 10.1016/j.jhealeco.2008.09.003
Clark, D. & Royer, H. The effect of education on adult mortality and health: Evidence from Britain. Am. Econ. Rev. 103, 2087–2120 (2013).
pubmed: 29533059
doi: 10.1257/aer.103.6.2087
Gathmann, C., Jürges, H. & Reinhold, S. Compulsory schooling reforms, education and mortality in twentieth century Europe. Soc. Sci. Med. 127, 74–82 (2015).
pubmed: 24560098
doi: 10.1016/j.socscimed.2014.01.037
Börsch-Supan, A. et al. Data resource profile: The survey of health, ageing and retirement in Europe (SHARE). Int. J. Epidemiol. 42, 992–1001 (2013).
pubmed: 23778574
pmcid: 3780997
doi: 10.1093/ije/dyt088
UNESCO. Classifying educational programmes. Manual for ISCED-97 Implementation in OECD Countries. Classifying Educ. Programme (1999).
Horackova, K. et al. Prevalence of late-life depression and gap in mental health service use across European regions. Eur. Psychiatry 57, 19–25 (2019).
pubmed: 30658276
doi: 10.1016/j.eurpsy.2018.12.002
Cermakova, P., Pikhart, H., Ruiz, M., Kubinova, R. & Bobak, M. Socioeconomic position in childhood and depressive symptoms in later adulthood in the Czech Republic. J. Affect. Disord. 272, 17–23 (2020).
pubmed: 32379611
doi: 10.1016/j.jad.2020.03.099
Kucera, M., Wolfová, K. & Cermakova, P. Changes in depressive symptoms of older adults in the Czech Republic. J. Affect. Disord. 261, 139–144 (2020).
pubmed: 31627114
doi: 10.1016/j.jad.2019.10.016
Onder, G. et al. Measures of physical performance and risk for progressive and catastrophic disability: Results from the women’s health and aging study. J. Gerontol. A. Biol. Sci. Med. Sci. 60, 74–79 (2005).
pubmed: 15741286
doi: 10.1093/gerona/60.1.74
Han, K.-M. et al. Relationships between hand-grip strength, socioeconomic status, and depressive symptoms in community-dwelling older adults. J. Affect. Disord. 252, 263–270 (2019).
pubmed: 30991254
doi: 10.1016/j.jad.2019.04.023
Kim, J.-H. Effect of grip strength on mental health. J. Affect. Disord. 245, 371–376 (2019).
pubmed: 30423464
doi: 10.1016/j.jad.2018.11.017
Schlicht, R., Stadelmann-Steffen, I. & Freitag, M. Educational Inequality in the EU. Eur. Union Polit. 11, 29–59 (2010).
doi: 10.1177/1465116509346387
Hyde, M. Comparison of the effects of low childhood socioeconomic position and low adulthood socioeconomic position on self rated health in four European studies. J. Epidemiol. Community Health 60, 882–886 (2006).
pubmed: 16973536
pmcid: 2566057
doi: 10.1136/jech.2005.043083
Csajbók, Z. et al. Sex differences in the association of childhood socioeconomic position and later-life depressive symptoms in Europe: The mediating effect of education. Soc. Psychiatry Psychiatr. Epidemiol. 56, 1091–1101 (2021).
pubmed: 33420794
doi: 10.1007/s00127-020-02018-0
Kotimäki, S., Härkönen, J., Karlsson, L., Karlsson, H. & Scheinin, N. M. Educational differences in prenatal anxiety and depressive symptoms and the role of childhood circumstances. SSM - Popul. Health 12, 100690 (2020).
pubmed: 33304984
pmcid: 7708856
doi: 10.1016/j.ssmph.2020.100690
Vilaplana-Pérez, A. et al. Much more than just shyness: The impact of social anxiety disorder on educational performance across the lifespan. Psychol. Med. 51, 861–869 (2021).
pubmed: 31907098
doi: 10.1017/S0033291719003908
Tambs, K. et al. Genetic and environmental contributions to the relationship between education and anxiety disorders—A twin study. Acta Psychiatr. Scand. 125, 203–212 (2012).
pubmed: 22111622
doi: 10.1111/j.1600-0447.2011.01799.x
Van Ameringen, M., Mancini, C. & Farvolden, P. The impact of anxiety disorders on educational achievement. J. Anxiety Disord. 17, 561–571 (2003).
pubmed: 12941366
doi: 10.1016/S0887-6185(02)00228-1
Juruena, M. F., Eror, F., Cleare, A. J. & Young, A. H. The role of early life stress in HPA axis and anxiety. In Advances in Experimental Medicine and Biology vol. 1191 (2020).
Faravelli, C. Childhood stressful events, HPA axis and anxiety disorders. World J. Psychiatry 2, 13 (2012).
pubmed: 24175164
pmcid: 3782172
doi: 10.5498/wjp.v2.i1.13
McLaughlin, K. A. et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II. Arch. Gen. Psychiatry 67, 124 (2010).
pubmed: 20124112
pmcid: 2847359
doi: 10.1001/archgenpsychiatry.2009.187
Morales, D. A., Barksdale, C. L. & Beckel-Mitchener, A. C. A call to action to address rural mental health disparities. J. Clin. Transl. Sci. 4, 463–467 (2020).
pubmed: 33244437
pmcid: 7681156
doi: 10.1017/cts.2020.42
Pryor, L., Strandberg-Larsen, K., Nybo Andersen, A. M., Hulvej Rod, N. & Melchior, M. Trajectories of family poverty and children’s mental health: Results from the Danish National Birth Cohort. Soc. Sci. Med. 220, 371–378 (2019).
pubmed: 30513487
doi: 10.1016/j.socscimed.2018.10.023
Muszyńska-Spielauer, M. & Spielauer, M. Cross-sectional estimates of population health from the survey of health and retirement in Europe (SHARE) are biased due to health-related sample attrition. SSM - Popul. Health 20, 101290 (2022).
pubmed: 36444337
pmcid: 9700319
doi: 10.1016/j.ssmph.2022.101290
Bago d’Uva, T., O’Donnell, O. & Van Doorslaer, E. Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans. Int. J. Epidemiol. 37, 1375–1383 (2008).
pmcid: 2734070
doi: 10.1093/ije/dyn146
Jürges, H. True health vs response styles: Exploring cross-country differences in self-reported health. Health Econ. 16, 163–178 (2007).
pubmed: 16941555
doi: 10.1002/hec.1134