Evidence map›Paper›PMID 29352539›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2018

Income inequality and depression: a systematic review and meta-analysis of the association and a scoping review of mechanisms.

Vikram Patel, Jonathan K Burns, Monisha Dhingra, Leslie Tarver, Brandon A Kohrt, Crick Lund

Erratum issued Registry-linked trialAbstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06295250 (ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women), which is not on this map. Cited by 243 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
243citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06295250 narecruitingnot on this mapstarted 2024, after this paper: background citation

ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women

TypeinterventionalSponsorUniversity of Massachusetts, WorcesterRan2024 to 2026Enrolled600ConditionsDepression, Economic Vulnerability, Anxiety, Culture Specific SymptomsArmsManualized Group Based Psychotherapy, Poverty Alleviation
3 · Its place in the literature

Who cites it

243 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  20. Depression trends in Europe: sociodemographic differences.European journal of public health · 2026
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183 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Vikram PatelDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Jonathan K BurnsInstitute of Health Research, University of Exeter, Exeter, UK.
Monisha DhingraAshoka University, Sonepat, Rai, Haryana, India.
Leslie TarverDepartment of Psychiatry, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Boston, MA, USA.
Brandon A KohrtDepartment of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA.
Crick LundHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Funding

ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) Scale-UpU19MH113211 · NIMH · HARVARD MEDICAL SCHOOL · PI PATEL, VIKRAM H · 2017 to 2023
$3.7M
Reducing Barriers to Mental Health Task SharingK01MH104310 · NIMH · GEORGE WASHINGTON UNIVERSITY · PI KOHRT, BRANDON ALAN · 2014 to 2018
$908k
Optimizing Provider Attitudes and Competence in Learning Mental Health Systems (OPAL)R21MH111280 · NIMH · GEORGE WASHINGTON UNIVERSITY · PI GIRMA, ESHETU, KOHRT, BRANDON ALAN · 2016 to 2017
$369k
NIMH NIH HHS K01 MH104310NIMH NIH HHS R21 MH111280NIMH NIH HHS U19 MH113211Wellcome Trust
6 · The paper itself

Abstract

Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high-income countries. Nearly two-thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta-analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07-1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low-income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo-material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality.

Indexed as

depressionIncome inequalitylow-income populationsneo-material hypothesispsychological stresssocial capitalsocial comparisonsocial defeat

Identifiers

PMID29352539
PMCPMC5775138

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.