SCHIZOPHRENIA AND SOCIAL CLASS

PRESENTED BY: ASHLEY DEDRICK

BACKGROUND

 Published in 1963 by E. M. Goldberg and S. L. Morrison

 Previous studies had shown that schizophrenia admission rates were higher in central slum districts than the rest of
the city of Chicago
 Studies also showed an association between hospital admission with a diagnosis of schizophrenia and low social
status
 Men in unskilled jobs had the highest admission rates
STUDY DESIGN

 Conducted of two parts: Documentary Study and Clinical Study

 Looking at occupation of male patients, as well as their father’s occupation
 Overall hypothesis: Before their first admission to mental hospitals, do men drift down the occupation scale to
unskilled jobs due to their premorbid personality or developing illness?
DOCUMENTARY STUDY

 Developed midway through the clinical study

 Testing that upon first admission to mental hospitals with a diagnosis of schizophrenia, young male patients who
marked an excess of Class V jobs right before being admitted, were born into families that had a social class
composition similar to the general population
 Used cards collected from the General Register Office that have the name, occupation, date of birth, and diagnosis
of every patient admitted to a mental hospital in Wales and England
 Selected males aged 20-34 years at time of admission who’s last name began with A to H for a total of 672 cards
 Concluded that the socio-economic environment that the patients grew up in was consistent with sample
population and not a major factor for the development of schizophrenia
DOCUMENTARY STUDY
CLINICAL STUDY

 To learn more about the social “drift” in male schizophrenic patients

 Studied series of admission of men under the age of 30 at two different hospitals
 Hospital A saw patients in a suburban community of Greater London and a working class district near the London docks from
January 1958 to December 1960
 Hospital B saw patients of a working class society near East London from March 1959 to April 1960
 Psychiatrists at the hospitals allocated patients into three diagnostic categories: definitely schizophrenic (S), possibly
schizophrenic (PS), and definitely not schizophrenic (NS)
CLINICAL STUDY
CLINICAL STUDY
CLINICAL STUDY

 Based on patients history, difficulties related to worked started in adolescence

 Boys who attended grammar school had fathers working in social classes I and II
 Social drift was confirmed as a decline in occupational status from father to son is seen in the patients’ own
history
 Social drift affected highest and lowest social classes the most
EPIDEMIOLOGIC IMPORTANCE

 Studied concluded that gross socio-economic deprivation is unlikely in being a major etiological significance in
schizophrenia
 Further studies needed as occupational factors appear to have an influence of the course of the disease but was
not clearly defined at time of study
Reference

 Goldberg, E. M., & Morrison, S. L. (1963). Schizophrenia and Social Class. The British Journal of Psychiatry:
The Journal of Mental Science, 109, 785-802