PART I of this study showed that we had to impose a control for class in order to find demographic differences between depressed and nondepressed medical inpatients. Additionally, there were differences from class to class. One measure (the clinical diagnosis) indicated that depression was most frequent in the upper class, while others (Beck Depression Inventory [BDI]1 and Hamilton Rating Scale for Depression [HRS]2) revealed a greater frequency in the lower class. Inasmuch as the medical staff diagnosed depression in 32% of the upper class but in only 8% of the lower, we wondered whether poverty, lack of education, and low social status obscured the clinical picture of depression so that many of the lower-class patients were not diagnosed. Therefore, because we suspected that there would be class differences in the manifestations as well as the frequency of depression, we undertook an analysis of the
Schwab JJ, Bialow MR, Brown JM, Holzer CE, Stevenson BE. Sociocultural Aspects of Depression in Medical Inpatients: II. Symptomatology and Class. Arch Gen Psychiatry. 1967;17(5):539–543. doi:10.1001/archpsyc.1967.01730290027004
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