Introduction
Method
Data sources
Cohort description
Education
Individual characteristics
Area-level characteristics
Bereavement
Mental health
Analytical strategy
Results
Characteristic | Group size | % Cohort | % Bereaved relative | % on AD |
p
|
---|---|---|---|---|---|
Gender
| |||||
Male | 98,313 | 47.2 | 7.3 | 8.3 | * |
Female | 110,019 | 52.8 | 8.6 | 16.7 | * |
Age group (at 2001 census)
| |||||
25–34 years | 51,883 | 24.9 | 5.1 | 10.9 | * |
35–44 years | 57,614 | 27.7 | 5.1 | 13.6 | * |
45–54 years | 46,182 | 22.2 | 7.2 | 14.1 | * |
55–64 years | 33,899 | 16.3 | 11.0 | 12.5 | * |
65–74 years | 18,754 | 9.0 | 21.1 | 12.2 | * |
Marital status
| |||||
Single | 27,462 | 13.2 | 19.9 | 11.8 | * |
Married | 154,366 | 74.1 | 6.4 | 11.9 | * |
Co-habiting | 9899 | 4.8 | 3.2 | 12.4 | * |
Separated/divorced | 12,033 | 5.8 | 5.8 | 23.7 | * |
Widowed | 4572 | 2.2 | 4.4 | 16.5 | * |
Limiting long-term illness
| |||||
No | 165,337 | 79.4 | 7.1 | 9.7 | * |
Yes | 42,995 | 20.6 | 11.4 | 24.2 | * |
Education
| |||||
No qualifications | 93,064 | 44.7 | 10.9 | 15.9 | * |
Foundation | 36,735 | 17.6 | 5.4 | 12.7 | * |
5+ GSCE | 30,040 | 14.4 | 6.3 | 10.7 | * |
A levels | 13,269 | 6.4 | 5.0 | 10.0 | * |
Degree or higher | 35,224 | 16.9 | 5.4 | 7.2 | * |
NSSEC
| |||||
Never work/unemployed | 4931 | 2.4 | 13.3 | 14.0 | * |
Routine/semi-routine | 68,946 | 33.1 | 9.3 | 16.5 | * |
Lower technical | 19,130 | 9.2 | 7.8 | 11.9 | * |
Own business | 13,452 | 6.4 | 7.5 | 8.3 | * |
Professional | 94,614 | 45.4 | 6.5 | 9.9 | * |
Student | 871 | 0.4 | 6.2 | 11.3 | * |
Economically inactive | 6415 | 3.1 | 13.5 | 24.7 | * |
Car access
| |||||
No car | 22,056 | 10.6 | 12.6 | 21.6 | * |
1 car | 87,933 | 42.2 | 8.7 | 14.3 | * |
≥2 cars | 98,343 | 47.2 | 6.3 | 9.4 | * |
House tenure
| |||||
Own house | 172,955 | 83.0 | 7.6 | 11.1 | * |
Renting | 35,377 | 17.0 | 10.0 | 20.9 | * |
Urban/rural
| |||||
Urban | 78,384 | 37.6 | 7.9 | 13.9 | * |
Intermediate | 70,032 | 33.8 | 7.2 | 13.5 | * |
Rural | 59,646 | 28.6 | 9.0 | 9.2 | * |
Area-level deprivation
| |||||
Least deprived | 42,575 | 20.4 | 5.9 | 9.2 | * |
2 | 42,655 | 20.5 | 7.0 | 11.2 | * |
3 | 40,050 | 19.2 | 8.0 | 12.4 | * |
4 | 38,549 | 18.5 | 9.1 | 14.4 | * |
Most deprived | 33,579 | 16.1 | 9.9 | 18.3 | * |
Missing | 10,924 | 5.2 | 9.9 | 11.1 | * |
Bereavement status
| |||||
No bereavement | 191,720 | 92.0 | 0 | 12.4 | * |
Bereaved by illness/other | 15,812 | 67.6 | 95.2 | 15.7 | * |
Bereaved by sudden death | 487 | 0.2 | 2.9 | 22.4 | * |
Bereaved by suicide | 313 | 0.2 | 1.9 | 26.5 | * |
Bereavement exposure and antidepressant use
Likelihood of antidepressant use given educational attainment
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |
---|---|---|---|---|---|
Unadjusted | +Adj sex, age, marital status and illness | +Adj SES (NSSEC, tenure and car access) | +Adj conurbation and area-level deprivation | +Adj bereavement status | |
Highest educational qualification | |||||
None | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Foundation | 0.78 (0.75, 0.80) | 0.78 (0.75, 0.81) | 0.86 (0.82, 0.89) | 0.86 (0.83, 0.90) | 0.86 (0.83, 0.90) |
5+GCSE | 0.65 (0.63, 0.68) | 0.66 (0.64, 0.69) | 0.77 (0.73, 0.80) | 0.77 (0.73, 0.81) | 0.77 (0.74, 0.81) |
A levels | 0.60 (0.57, 0.64) | 0.63 (0.60, 0.68) | 0.74 (0.70, 0.79) | 0.74 (0.70, 0.79) | 0.75 (0.70, 0.80) |
Degree+ | 0.42 (0.40,0.44) | 0.50 (0.48,0.53) | 0.61 (0.58,0.64) | 0.61 (0.58,0.65) | 0.62 (0.58,0.65) |
Gender | |||||
Male | 1.00 | 1.00 | 1.00 | 1.00 | |
Female | 2.21 (2.15,2.28) | 2.12 (2.06,2.18) | 2.12 (2.06,2.19) | 2.11 (2.05,2.18) | |
Age (at 2001 census) | |||||
25–34 years | 1.00 | 1.00 | 1.00 | 1.00 | |
35–44 years | 1.12 (1.08,1.17) | 1.16 (1.11,1.20) | 1.16 (1.12,1.21) | 1.15 (1.11,1.20) | |
45–54 years | 1.05 (1.00,1.10) | 1.13 (1.08,1.18) | 1.13 (1.09,1.18) | 1.12 (1.07,1.17) | |
55–64 years | 0.73 (0.70,0.77) | 0.79 (0.75,0.82) | 0.79 (0.75,0.83) | 0.77 (0.73,0.81) | |
65–74 years | 0.63 (0.60,0.67) | 0.66 (0.62,0.70) | 0.67 (0.63,0.71) | 0.64 (0.60,0.68) | |
Marital status | |||||
Married | 1.00 | 1.00 | 1.00 | 1.00 | |
Single | 1.00 (0.96,1.04) | 0.90 (0.86,0.94) | 0.90 (0.86,0.94) | 0.87 (0.83,0.91) | |
Co-habiting | 1.12 (1.05,1.20) | 1.03 (0.97,1.10) | 1.02 (0.96,1.09) | 1.02 (0.95,1.09) | |
Separated/divorced | 1.56 (1.49,1.64) | 1.29 (1.23,1.36) | 1.28 (1.22,1.35) | 1.28 (1.22,1.35) | |
Widowed | 1.02 (0.94,1.11) | 0.96 (0.88,1.04) | 0.95 (0.88,1.04) | 0.97 (0.90,1.06) | |
Limiting long-term illness | |||||
No | 1.00 | 1.00 | 1.00 | 1.00 | |
Yes | 2.84 (2.76,2.94) | 2.68 (2.60,2.77) | 2.67 (2.59,2.76) | 2.67 (2.59,2.76) | |
NSSEC | |||||
Professional | 1.00 | 1.00 | 1.00 | ||
Own business | 0.89 (0.84,0.96) | 0.91 (0.85,0.98) | 0.91 (0.85,0.98) | ||
Lower technical routine/semi-routine | 1.06 (1.01,1.12) | 1.05 (0.99,1.10) | 1.05 (0.99,1.10) | ||
Never work/unemployed | 1.11 (1.08,1.15) | 1.10 (1.06,1.14) | 1.10 (1.06,1.14) | ||
Student | 1.00 (0.92,1.10) | 1.00 (0.92,1.09) | 1.00 (0.91,1.09) | ||
Economically | 0.98 (0.79,1.22) | 0.98 (0.79,1.22) | 0.99 (0.79,1.23) | ||
Inactive | 1.17 (1.10,1.26) | 1.18 (1.10,1.26) | 1.17 (1.09,1.25) | ||
Car access | |||||
≥2 Cars | 1.00 | 1.00 | 1.00 | ||
1 Car | 1.21 (1.18,1.25) | 1.17 (1.13,1.23) | 1.17 (1.13,1.21) | ||
No car | 1.34 (1.28,1.41) | 1.26 (1.20,1.33) | 1.26 (1.19,1.32) | ||
House tenure | |||||
Own house | 1.00 | 1.00 | 1.00 | ||
Renting | 1.32 (1.27,1.37) | 1.29 (1.24,1.34) | 1.29 (1.24,1.34) | ||
Urban/rural | |||||
Rural | 1.00 | 1.00 | |||
Intermediate | 1.18 (1.14,1.23) | 1.19 (1.14,1.24) | |||
Urban | 1.18 (1.12,1.24) | 1.18 (1.12,1.24) | |||
Deprivation | |||||
Least deprived | 1.00 | 1.00 | |||
2 | 1.13 (1.08,1.19) | 1.13 (1.07,1.18) | |||
3 | 1.13 (1.08,1.19) | 1.13 (1.08,1.19) | |||
4 | 1.17 (1.11,1.23) | 1.16 (1.11,1.22) | |||
Most deprived | 1.23 (1.17,1.30) | 1.23 (1.16,1.29) | |||
Missing | 1.16 (1.08,1.25) | 1.16 (1.07,1.25) | |||
Bereavement status | |||||
No bereavement | 1.00 | ||||
Bereaved by illness/other | 1.22 (1.16,1.29) | ||||
Bereaved sudden death | 1.83 (1.46,2.29) | ||||
Bereaved by suicide | 1.85 (1.85,2.41) | ||||
χ
2 (MLM vs. logistic) | 1043.77 | 584.56 | 449.77 | 396.86 | 395.86 |
p
| 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |
Variance | 0.082 | 0.057 | 0.048 | 0.044 | 0.044 |
Variance partition coefficient | 2.43 | 1.70 | 1.32 | 1.32 | 1.32 |
% Population on antidepressants | Model 1 | Model 2 | Model 3 | Model 4 | ||
---|---|---|---|---|---|---|
Unadjusted | +Adj sex, age, marital status and illness | +Adj SES (NSSEC, tenure and car) | +Adj conurbation and area deprivation | |||
No bereavement (n = 191,720) | 12.4 |
Educational attainment
| ||||
No qualifications | 1.00 | 1.00 | 1.00 | 1.00 | ||
Foundation level | 0.78 (0.75, 0.81) | 0.78 (0.75, 0.81) | 0.85 (0.82, 0.89) | 0.86 (0.82, 0.89) | ||
5+ GSCE | 0.65 (0.63, 0.68) | 0.66 (0.63, 0.69) | 0.76 (0.72, 0.80) | 0.76 (0.73, 0.80) | ||
Secondary level (A levels) | 0.61 (0.57, 0.65) | 0.64 (0.60, 0.68) | 0.74 (0.69, 0.79) | 0.75 (0.70, 0.80) | ||
Third level (degree+) | 0.42 (0.40,0.44) | 0.50 (0.47, 0.52) | 0.60 (0.57, 0.64) | 0.61 (0.58, 0.64) | ||
Bereaved by illness/other (n = 15,812) | 15.7 |
Educational attainment
| ||||
No qualifications | 1.00 | 1.00 | 1.00 | 1.00 | ||
Foundation level | 0.81 (0.71, 0.94) | 0.89 (0.76, 1.03) | 0.96 (0.82, 1.12) | 0.95 (0.81, 1.10) | ||
5+ GSCE | 0.71 (0.61, 0.82) | 0.76 (0.65, 0.89) | 0.87 (0.74, 1.02) | 0.86 (0.73, 1.02) | ||
Secondary level (A levels) | 0.57 (0.44, 0.73) | 0.65 (0.50, 0.85) | 0.74 (0.56, 0.97) | 0.73 (0.55, 0.96) | ||
Third level (degree+) | 0.51 (0.44, 0.60) | 0.62 (0.53, 0.74) | 0.74 (0.61, 0.89) | 0.73 (0.61, 0.88) | ||
Bereaved by sudden death (n = 487) | 22.4 |
Educational attainment
| ||||
No qualifications | 1.00 | 1.00 | 1.00 | 1.00 | ||
Foundation level | 0.49 (0.24, 1.00) | 0.46 (0.21, 1.01) | 0.45 (0.19, 1.03) | 0.41 (0.18, 0.96) | ||
5+ GSCE | 0.40 (0.18, 0.89) | 0.38 (0.17, 0.86) | 0.38 (0.15, 0.93) | 0.37 (0.15, 0.92) | ||
Secondary level (A levels) | 0.57 (0.19, 1.75) | 0.44 (0.13, 1.47) | 0.40 (0.11, 1.44) | 0.36 (0.10, 1.31) | ||
Third level (degree+) | 0.33 (0.14, 0.80) | 0.32 (0.13, 0.82) | 0.29 (0.11, 0.82) | 0.27 (0.09, 0.75) | ||
Bereaved by suicide (n = 313) | 26.5 |
Educational attainment
| ||||
No qualifications | 1.00 | 1.00 | 1.00 | 1.00 | ||
Foundation level | 0.91 (0.45, 1.85) | 1.16 (0.52, 2.62) | 1.26 (0.50, 3.15) | 1.26 (0.48, 3.32) | ||
5+ GSCE | 0.58 (0.21, 1.67) | 0.67 (0.22, 2.02) | 0.85 (0.23, 3.14) | 0.86 (0.22, 3.37) | ||
Secondary level (A levels) | 0.86 (0.26, 2.81) | 0.79 (0.22, 2.78) | 1.07 (0.24, 4.83) | 0.96 (0.21, 4.50) | ||
Third level (degree+) | 0.49 (0.14, 1.70) | 0.86 (0.23, 3.15) | 0.98 (0.21, 4.54) | 1.42 (0.29, 7.00) |