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Educational differences in psychological distress? Results from a population-based sample of men and women in Sweden in 2012
  1. Anu Molarius1,2,
  2. Fredrik Granström3
  1. 1 Competence Centre for Health, Region Västmanland, Vasteras, Sweden
  2. 2 Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
  3. 3 Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  1. Correspondence to Dr Anu Molarius; anu.molarius{at}


Background Mental health problems are more frequent in socially disadvantaged groups, but the results vary between different studies, different populations and different measures of mental health. This paper investigated the association between educational level, economic difficulties and psychological distress in men and women in Sweden.

Methods The study population included 24 510 respondents aged 25–74 years who responded to a survey questionnaire in Mid-Sweden in 2012 (response rate 53%). Psychological distress was measured with the 12-item version of the General Health Questionnaire, and multivariate logistic regression models were used in statistical analyses, adjusting for age, employment status and social support.

Results The prevalence of psychological distress was higher in women (16.4%) than in men (11.3%; p<0.001). Persons with low and medium educational level had a lower risk of psychological distress than persons with high educational level after adjustment for confounders. Economic difficulties had a strong association with psychological distress (OR 2.80 (95% CI 2.39 to 3.27) and OR 2.40 (95% CI 2.12 to 3.71) in men and women, respectively) after adjustment for confounders.

Conclusion We found a strong association between economic difficulties and psychological distress in this study, but no inverse association between educational level and psychological distress. On the contrary, persons with high education had more psychological distress than persons with low and medium education when age, employment status and social support were taken into account. The findings were similar in men and women.

  • mental health
  • public health
  • epidemiology
  • social medicine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors AM conceived the study and analysed the data. Both authors interpreted the results, drafted and critically revised the manuscript and read and approved the final manuscript.

  • Funding The survey was funded by the County Councils of Västmanland (now Region Västmanland), Sörmland, Uppsala and Örebro.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The survey was approved by the regional ethical review board in Uppsala (EPN 2012/256).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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