Class exploitation and psychiatric disorders: From status syndrome to capitalist syndrome

Psychiatric epidemiologists were among the first scientists to document that the poor suffer from a higher rate of psychiatric disorders than the affluent. Psychiatric disorders and, more precisely, psychiatric research have propelled many studies on social class and psychiatricdisorders which reflect the humanistic concerns of psychiatrists. These studies were motivated by a desire to improve the living conditions of workers, immigrants, and racial or ethnic minorities (e.g., Blazer et al., 1994; Eaton et al,2004; Jacobi et al., 2004; Lahelma et al., 2005; Regier et al.,1988; Roberts & Lee, 1993).The absence or poor quality of psychiatric careforpoor working class, immigrant, or racial and ethnic minority populations (Muntaner et al.,1995a;Alegria et al., 2000; Cohen et al., 2006) raised a related set of concerns about the implications of economic inequality for the treatment of psychiatric disorders.The psychiatric and public health perspective on social class has been characteristically “pragmatic” (e.g., Asthana et al., 2004). Following the ethos of public health and medical care, the goal has been to“act upon the world” to reduce suffering and increase well-being (Navarro &Muntaner, 2004).Psychiatric disorders, which have a major worldwide impact on disability, arethe leading cause of disability among women and, by 2020, are expected to become the main cause of years lost to disability (Murray & Lopez, 1996).