Social class trajectory and psychotic disorders: A comparison between schizophrenia, bipolar disorder, major depressive disorder, and community non-cases

The present study examines differences in inter- and intra-generational social class trajectory among patients with schizophrenia, bipolar disorder, major depressive disorder and community non-cases. Data were collected between 1983 and 1989 by interviewing all psychotic admissions to fifteen hospitals providing inpatient psychiatric services in the Baltimore Metropolitan Area. Social class of the patient's family of origin and the patient's own social class at the time of admission were obtained through standard survey questions on occupation. Inter-generational differences in social class suggest a lower origin social class for psychotic patients with major depressive disorder than for patients with bipolar disorder, schizophrenia or community non-cases. A multi-group structural equation analysis showed that the magnitude of the effect of educational achievement on social class at the time of hospital admission is strongly patterned after by type of psychotic disorder. Patients with schizophrenia showed a more pronounced "downward drift" (lower returns to education) than patients with bipolar disorder, major depressive disorder and community controls.