Socio-economic mobility among patients with schizophrenia or major affective disorder. A 17-year retrospective follow-up.

Background: Social mobility among patients with schizophrenia or major affective disorder was compared with that among the general population.

Method: Mobility was studied retrospectively from 1970 to 1987. Socio-economic status (SES) was defined by occupation as in the population census (upper white-collar, lower white-collar, blue-collar, entrepreneur, farmer, unemployed). All patients aged 30-60 years at discharge (2901 men and 3620 women) in 1987-88 in Finland were included in the study. The SES structure of the general population was used for comparisons.

Results: Among patients with schizophrenia there was a constant downward drift, commonly to unemployment. This risk was higher among men than women. In the youngest age group a marked decline from the parents' social status was observed. Among patients with major affective disorder the distribution of SES in 1970 was similar to that of the general population. By 1987, a downward drift was again observed, mainly to unemployment regardless of the initial SES group. The number of patients in occupational categories were usually 30-50% lower than expected.

Conclusions: Schizophrenic patients had a high risk of social drop-out. Among patients with major affective disorder the downward drift was much less.