The vicious circle between mental disorders and social inequality


Are there any causal links between poverty and mental disorders? If so, studying the mechanisms underlying this relationship can prove to be fundamental for making targeted political choices, which promote the reproduction of a virtuous circle between psychological well-being and improvement of economic conditions. This is the thesis put forward in a systematic review work conducted by Matthew Ridley, of the economics department at MIT, together with other researchers of the same structure and of Harvard. Their aim was to understand the complex and multidimensional relationship between poverty and mental disorders by analyzing the experimental results obtained in several studies showing a positive effect of mental illness treatment on employment. Their results were published in Science.

For a long time, the study authors report,

anxiety and depression were considered “diseases of well-being”, that is, capable of affecting mainly those who belonged to the upper classes. This thesis, according to the authors, is substantially false, because the studies they considered have shown that, on the contrary, it is those who live in poverty who run a greater risk of suffering from mental disorders. Their study seems to show that job loss and difficult living conditions are often linked to the onset of mental disorders such as anxiety and depression.

Why have these ailments had a reputation as a disease of well-being for so long?

And how has this belief been discredited? We asked Professor Daniela Palomba, director of the University Center of Psychological University Clinical Services (SCUP), aimed at students and employees of the University of Padua, which includes among its activities the early identification of anxiety and depression and development of scientific protocols for their prevention and treatment.

This is a theme that takes us back to the period of ’68 and post ’68

Especially when the movements of democratic medicine and democratic psychiatry began, which denounced the hierarchical structure of medical systems in access to care. As early as the mid-1960s, August Hollingshead and Frederick C. Redlich, who were respectively a sociologist and a psychiatrist at Yale University, wrote the book Social Classes and Mental Illnesses, in which they reported data from a survey, from which concluded that various mental disorders are significantly linked to social stratification and that the treatment of mental disorders themselves also reflected social stratification.

The problem, therefore, was not only whether those of a certain social class suffered specifically from mental disorders,

but whether those who were socially disadvantaged had an equal chance of being cured. Finally, they showed that the type of treatment prescribed by psychiatrists was also related to the patient’s social affiliation.
The current rapid spread of the Improving Access to Psychological Therapies (IAPT) program is the clearest demonstration of the priority importance of ensuring access to care for adequate treatment of mental disorder and, in particular, anxiety and depression ”


“We must remember that there are different forms of depression”, continues Professor Palomba, “and a first broad distinction can be made between the so-called endogenous depression, a form of depression strongly characterized by family, constitutional and often genetic characteristics that can manifest itself in anyone in a way that is often detached from social class, and so-called reactive depression, which is instead favored by the occurrence of adverse events, such as failure or a critical situation, such as the one we are experiencing in this period.


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