Mental disorder diagnoses as predictors of behavioural risk factors: the moderating role of socioeconomic status.

Background: Health inequities have drawn increasing attention, yet evidence on the moderating role of socioeconomic status (SES) in the relationship between mental disorders and multiple behavioural risks is inconsistent. This study examines the role of SES in the relationship between prior mental disorder diagnoses and later multiple behavioural risks.

Methods: The study was based on registry-linked survey data from 2021-2022 among the Estonian adult population. The analytic sample included 1,561 individuals aged >25. Poisson regression was used to examine associations between mental disorders and behavioural risks. Latent class analysis was used to identify behavioural risk classes, and multinomial logistic regression to assess their relationship with prior diagnoses.

Results: Depression was associated with a higher number of behavioural risks and higher odds of belonging to multiple risk classes, while anxiety was linked to the overweight/obesity class. Lower SES index, secondary education, and medium income were associated with increased behavioural risks compared to higher SES index, education, and income. While the SES index showed no interactions, education and income demonstrated moderating effects. Respondents with medium income and depression had lower risk of behavioural risks and lower odds of belonging to multiple risk classes, compared to the higher-income group. Individuals with anxiety and secondary education had a lower risk of behavioural risks and lower odds of the overweight/obesity category, compared to those with higher education.

Conclusion: These results highlight the relevance of socioeconomic context and the need for further longitudinal research. Findings point to the importance of addressing behavioural risks within psychiatric care.