Psychosocial risk factors, inequality and self-rated morbidity in a changing society

The aim of this study was to analyse the interaction of social, economic, psychological and self-rated health characteristics of the Hungarian population in representative, stratified nation-wide samples during the period of sudden political-economic changes. In 1988 20,902 and in 1995 12,640 persons, representing the Hungarian population over the age of 16 by age, sex and place of residence were interviewed. Self-rated morbidity characteristics, shortened Beck Depression Inventory, hopelessness, hostility, ways of coping, social support, control over working situation and socioeconomic characteristics were examined. Age dependent changes could be observed between 1988 and 1995 with increasing depressive symptomatology, hopelessness, lack of control over working situation in the population above 40 years, while in the younger population improvements in depressive symptomatology could be seen. According to hierarchical loglinear analysis,depressive symptom severity mediates between relative socioeconomic deprivation and higher self-rated morbidity rates, especially among men. Depressive symptomatology is closely connected with hostility, low control in working situation, low perceived social support and emotional ways of coping. A vicious circle might be hypothesised between socially deprived situation and depressive symptomatology, which together has a major role in higher self-rated morbidity rates. (C) 2000 Elsevier Science Ltd. All rights reserved.