The association between common mental disorders, socioeconomic outcomes and social mobility: A systematic review

The association between common mental disorders, socioeconomic outcomes and social mobility: A systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review The association between common mental disorders, socioeconomic outcomes and social mobility: A systematic review Iyinoluwa Deborah Oshinowo, Phoebe Barnett, Christopher Cooper, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2656092/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: The aim of this systematic review was to identify published evidence on the association between common mental disorders (CMDs), changes in socioeconomic outcomes, and social mobility. Methods: Systematic literature searches were conducted across seven databases up to May 2022. Quantitative studies were included based on the following criteria: 1) cohort study design, 2) the population had a common mental disorder, 3) Outcomes reported related to social mobility and social class (due to the limited direct measures of social mobility and social class, changes in socioeconomic outcomes were included as proxies of social mobility). The identified studies were analysed using narrative synthesis. Results: There was more evidence for the negative intragenerational than intergenerational association of CMDs on educational attainment, income, and occupational status. Considering the intergenerational association on educational attainment, there was an association between parental mental health disorders on parent-child interactions which subsequently affects their child’s mental health. This in turn may negatively impact their child’s educational progression. Only one study investigated the direct association of CMDs with changes in social class and subsequent social mobility. Conclusion: Given the evidence of the negative intragenerational association between CMDs and socioeconomic outcomes, it is important to promote mental health interventions adapted to the work and educational environment that adequately equip individuals to maintain their own mental health. Additionally, within the home environment, there is a need to further understand how negative parent-child interactions impact a child’s mental health and develop strategies to mitigate how this may impact subsequent social mobility. Systematic Review Social Mobility Mental health Common Mental Disorder Socio-economic Factors Figures Figure 1 1. Introduction The social selection and health selection theories have been proposed to explain how mental illness affects an individual’s social mobility [ 1 – 3 ]. These hypotheses state that individuals who experience mental illness are more likely to experience poverty, reduced economic productivity, and unemployment [ 1 – 3 ]. Social mobility is an individual’s upwards or downwards movement in social class and includes measures of income, education, and occupation. [ 4 – 6 ]. Amongst other factors, success in educational attainment, income and occupational status, have an important influence on an individual’s ability to function in society and experience upwards social mobility [ 7 , 8 ]. Individuals who experience upwards social mobility are more likely to maintain healthy relationships with their parents, spouse and friends; they are more likely to experience higher job satisfaction; and are more likely to find outside help in regards to attaining employment [ 7 ]. Common mental health disorders (anxiety disorders, depressive disorders and post-traumatic stress disorders (CMDs)) have increased in prevalence despite the rise in the use of mental health services [ 9 ]. Given the increased prevalence of CMDs and the importance of experiencing upwards social mobility, it is imperative to understand the association between CMDs, socioeconomic outcomes, and subsequent social mobility. However, there are limited reviews investigating this association, this includes both the intergenerational association (parental mental health problems and their children’s socioeconomic outcomes and social mobility), and the intragenerational association (a person’s own mental health problems and changes to their socioeconomic outcomes and social mobility outcomes) [ 1 , 5 , 10 – 13 ]. The aim of this systematic review is to synthesise current literature on the association between CMDs and changes to social mobility. Due to the lack of studies using strict measures of social mobility and social class, socioeconomic outcomes were used as proxies for social mobility including, education, occupation and income [ 4 – 6 , 14 ]. 2. Methods This systematic review was conducted as part of a wider project (initiated by the Social Mobility Commission, UK) investigating the association between mental health problems and social mobility. A complementary paper, which explored the association between social class and the effectiveness of interventions for mental health disorders has recently been published [ 15 ]. This review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) [ 16 ]. The protocol for this review paper was not registered on PROSPERO as the review considered social rather than health outcomes. However, the protocol was written apriori and was followed without amendments. The protocol can be found in online resource 1. The review questions and conclusions were informed by advice from an expert reference group (Online resource 1). 2.1 Search strategy The studies were identified using database and non-database search methods [ 17 , 18 ]. Seven bibliographic databases were searched including MEDLINE (1946-27/09/19), Embase (1980-27/09/19), PsycINFO (1806-09/19), Health Management Information Consortium (HMIC) (1979-05/19), Social Policy and Practice (SPP) (1890-27/09/2019), Applied Social Sciences Index and Abstracts (Assia) (01/01/1987–27/09/2019), and Education Resources Information Center (ERIC) (1966-27/09/19). An updated search was conducted on March 17th 2021 and on May 20th 2022, to ensure all up-to-date studies were included in the review. The search strategies were assessed using the PRESS checklist [ 19 ]. The primary search strategy is reported using a search narrative to explain the contextual and conceptual detail behind the selection of search terms [ 20 ]. The following study design search filters were used: Canadian Agency for Drugs and Technologies in Health (CADATH), RCT/controlled clinical trial (CCT), and Scottish Intercollegiate Guidelines Network (SIGN) [ 21 , 22 ]. The SIGN filter was adapted to target studies that report cohort or longitudinal designs. The searches were not limited by date or language. Non-database (supplementary) searches were also conducted [ 18 ], including: Checking systematic reviews for included studies that met the inclusion criteria not identified in the bibliographic searches. Web-searching was conducted by one researcher using Google advanced interface, following Briscoe’s guidance [ 23 ]. Identified studies that met inclusion criteria were shared with the expert reference group for them to identify any missing studies [ 17 ]. The studies were de-duplicated in EndNote X8 [ 19 ]. The full search strategy for the database and non-database search are reported in online resource 2. 2.2 Selection criteria Studies were included according to the following criteria: Cohort study design. Population with a CMD. Outcomes reported that relate to social mobility and social class*. (*Due to the limited data on measures of social mobility and social class, education, income, occupation and social class were included for study outcomes [ 14 ] ). Studies were not excluded based on language. Studies on drug and alcohol- use disorders or neurodevelopmental disorders were excluded. Conference abstracts, dissertations, and study protocols were also excluded. The list of excluded studies and reasons for exclusion can be found in online resource 3. 2.3 Study selection All studies were initially screened independently by two reviewers at title and abstract, using Rayyan software [ 24 ]. All studies that met inclusion at title and abstract were then double screened independently at full text. A third researcher was available where there were disagreements. 2.4 Quality appraisal The Newcastle-Ottawa tool (modified by Gondek et al. 2018) was used to assess the quality of studies. Quality appraisal was initially conducted by one reviewer and then checked in detail by a second reviewer [ 14 ]. Studies that received a score of seven were reported as “good” quality, a score of six “fair” quality, and a score of five “poor” quality. 2.5 Data Extraction Data was extracted using an extraction tool developed and tested by the research team. The following data were extracted: study reference, study design, country and region of the study, setting, age, gender, ethnicity, mental health diagnosis and specific disorder studied, population characteristic, study purpose, exposure, comparison, social mobility outcome measured, method of measurement, limitations, and outcome data relevant to our research question. 2.6 Data synthesis There was a high variability in study outcomes, populations, adjustments to statistics, and follow-up, therefore the data was synthesised narratively [ 25 ] by mental disorder and social mobility outcomes. Similar outcomes were grouped and differences between study outcomes were explained narratively. 3. Results 3.1 Search results A total of 4792 studies were identified by the bibliographic and non-bibliographic searches after duplicates were removed. 4691 studies were excluded at title and abstract screening. 101 studies were screened at full text, with a total of 23 studies meeting the inclusion criteria. A further four studies were identified from update searches. Overall, a total of 27 studies met inclusion for the review. The systematic review process is shown in Fig. 1 (PRISMA diagram). PRISMA Diagram Table 1 Characteristics of included studies Study reference Country (region) Sample size Study design Exposure Comparison Diagnostic criteria Mean age (range) Gender (% female) Ethnicity Follow-up Study quality Abebe et al. [ 26 ] Norway 12,287 Prospective cohort Mental health problems and a physical disability No mental health problems and a physical disability Not reported (NR) 28.5 (not recorded [NR]) 55.1 NR 13 years Poor quality (5) Amos et al. [ 27 ] US 39,479 Retrospective cohort Treatment-resistant depressive disorder No depressive disorder ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) NR (18–64) 64.2 NR 6 years Fair quality (6) Aro et al. [ 28 ] Finland 6,521 Retrospective cohort Major affective disorder No major affective disorder ICD-9 (Finnish version). which has adapted DSM-III-R criteria for mental disorders NR 55.5 NR 17 years Fair quality (6) Birtchnell [ 29 ] UK (Aberdeen) 4,159 Prospective cohort Depressive disorder No depressive disorder ICD-7 NR 0.0 NR Multiple Poor quality (4) Butterworth et al. [ 30 ] Australia (Melbourne) 13,969 Prospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR 35.85 (NR) 54.1 NR 5 years Good quality (7) Case et al. [ 31 ] UK 17,409 Prospective cohort Mental health and emotional problems No mental health and emotional problems NR NR NR NR 42 years Poor quality (4) Coryell et al. [ 32 ] US (Boston MA, Chicago IL, Iowa City IA, New York NY, St Louis MO) 480 Prospective cohort Depressive disorder No depressive disorder Research diagnostic criteria 39.15 (NR) 67.5 NR 6 years Fair quality (6) Christensen et al. [ 33 ] Denmark 108,102 Prospective Cohort Mental health problems (various) No mental health problems (various) NR 16–24 (education) 25–59 (employment) 46 NR education: 5 years employment: 4 years Fair quality (6) Eaton et al. [ 34 ] US (Baltimore MD) 907 Prospective cohort Depression disorder No depressive disorder NR 43.2 (NR) 55.1 NR 16 years Poor quality (3) Elovainio et al. [ 35 ] Finland 3,596 Prospective cohort Depressive disorder No depressive disorder NR 10.4 (NR) 53.8 NR 27 years Fair quality (4) Ensminger et al. [ 36 ] US (Chicago IL) 1,242 Prospective cohort Psychological distress No psychological distress Composite International Diagnostic Interview (CIDI) (Michigan version) according to the criteria of DSM-III-R NR NR NR NR Fair quality (5) Evans et al. [ 37 ] UK 7465 Retrospective cohort Parental postnatal mental health- Anxiety + Depression No parental mental health problems (less) NR NR NR NR Educational attainment at age 11, and rate of change in attainment age 7–16 Fair quality (6) Groffen et al. [ 38 ] Netherlands (Eindhoven) 4,745 Prospective cohort Social anxiety disorder No social anxiety disorder NR 68.9 (NR) 47.8 NR 3 years Fair quality (4) Halonen et al. [ 39 ] Finland (Northern Finland) 9,432 Retrospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR NR 50.0 NR 30 years Fair quality (5) Isohanni et al. [ 40 ] Finland (Northern Finland) 11,017 Prospective cohort Non-psychotic disorder No non-psychotic disorder DSM-III-R NR 49.0 NR NR Good quality (7) John et al. [ 41 ] Wales 437 412 Retrospective cohort Mental Disorders No mental health disorders Code lists adapted from ICD (version 10) for secondary care and read codes (version 2) 22 in primary care 10.5 (7–16) 48.9 NR 1–4 years Good quality (7) Johnson et al. [ 42 ] US (New York NY) 736 Prospective Cohort Anxiety and depressive disorders No anxiety or depressive disorders Diagnostic Interview Schedule for Children (DISC-I) 22.5 (NR) 51.0 White: 91% 19 years Good quality (5) Johnston et al. [ 43 ] UK (UK-wide) 8,496 Retrospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR NR 53.0 British: 100% 34 years Fair quality (4) Landstedt et al. [ 44 ] Sweden (North Sweden) 1,083 Retrospective cohort Depressive disorder No depressive disorder NR 42 (NR) 48.5 NR 26 years Poor quality (4) Meibner et al. [ 45 ] Germany 433 Prospective cohort Internalising Mental Health Problems (MHP) (inwards-oriented symptoms of anxiety, depression, and social difficulties) No internalizing MHP Emotional Symptoms Peer subscales adapted for internalised mental health problems score 14.88 (11.01–17.98) 54.7 6.7% two-sided migration background 6 years Good quality (6) Prause et al. [ 46 ] US 1,160 Retrospective cohort Depressive disorder No depressive disorder NR 33.2 (NR) NR NR 2 years Poor quality (3) Psychogiou et al. [ 47 ] UK (Avon) 13,988 Prospective cohort Depressive disorder No depressive disorder NR NR 48.6 NR 16 years Fair quality (5) Ritsher et al. [ 48 ] US (New Haven CT) 756 Retrospective cohort Depressive disorder No depressive disorder Diagnostic interview schedule for affective disorders and schizophrenia 25 (18–49) NR NR 17 years Good quality (5) Sareen et al. [ 49 ] US 34,653 Prospective cohort Mental health problems No mental health problems Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV NR NR NR 3 years Fair quality (4) Sellers et al. [ 50 ] UK 35,924 Prospective cohort Child mental health problems No child mental health problems NR NR 48.5 NR 9 years Fair quality (4) Slominski et al. [ 51 ] US 196 Retrospective cohort Mental health problems No mental health problems DSM structured psychiatric interview NR 55.0 European American: 63% African American: 34% Puerto Rican: 3% 3–30 years Fair quality (5) Tolman et al. [ 52 ] US (Michigan) 753 Prospective cohort Social anxiety disorder or major depressive disorder No mental health problem NR NR 100.0 Black: 56% White: 45% 1 year Fair quality (4) 3.2 The association between CMDs and socioeconomic outcomes All of the 27 studies investigated the intragenerational association between CMDs and changes in socioeconomic outcomes. Eight studies also investigated the intergenerational association between CMDs and changes in socioeconomic outcomes. One study [ 29 ] investigated the direct association between mental health and social mobility outcomes (change in social class from parent to child). Table 2 provides a summary of findings. Table 2 The association between common mental health disorders, socioeconomic outcomes, and social mobility Outcome Intragenerational/ intergenerational Mental health problem Age Study (quality) Findings Educational attainment Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s educational attainment after controlling for parental SES (f ratio [F] = 0, p = 0.97) Any common mental health problem b Adolescence Ensminger et al. [ 36 ] (Fair quality) Mothers’ distress during either their children’s childhood or adolescence did not significantly increase the odds of secondary school drop out in either sons (OR: 1.22, 95% CI: 0.72, 2.06, p = 0.458) or daughters (OR: 0.94, 95% CI: 0.55, 1.63, p = 0.823) when controlling for maternal educational attainment. Mothers’ distress during their children’s childhood and adolescence significantly increased the odds of secondary school drop out in sons (OR: 2.29, 95% CI: 1.20, 4.37, p = 0.012) but not in daughters (OR: 1.12, 95% CI: 0.50, 2.49, p = 0.782) when controlling for maternal educational attainment. There was a significant interaction between maternal distress and poverty: maternal distress at only one time point, when combined with poverty, did significantly increase the odds of school drop out in sons only (OR: 3.07, 95% CI: 1.02, 9.22, p = 0.046). Depressive and Anxiety disorders Childhood/Adolescence Evans et al. [ 37 ] (Fair quality) From ages 7–16, parental mental health (composite score measured 1–2 years after birth) was associated with a slightly slower rate of change in maths attainment (b=-0.004, 95% CI: -0.008, -0.00, p = 0.036). An increase in mental health symptoms (by 1-unit) was associated with a decrease in maths attainment improvement per year by − 0.004 levels. At age 11, parental mental health did not predict maths attainment (b=-0.019, 95% CI: -0.037, 0.000, p = 0.053). (Controlled for: Parental education, IQ, Working memory, at home teaching, involvement and interaction of parent, sex). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Worse mental health in mothers predicted reduced chances of their children gaining a degree by age 30 (b: -0.014, SE: 0.005, p 0.05). Children’s mental health mediated the effect of their mothers’ mental health and their own educational attainment. Depressive disorders Adolescence Psychogiou et al. [ 47 ] (Fair quality) More severe depression in mothers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative mother-child relationships (b:-0.01. SE:0.002, p < 0.001) and prior educational attainment (b:-0.004, SE: 0.001, p < 0.01). More severe depression in fathers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative father-child relationships (b: 0.008, SE: 0.003, p < 0.01). Any common mental health problem Adolescence/adult Slominski et al. [ 51 ] (Fair quality) There was no direct association between mothers’ mental health and their children’s educational attainment in adulthood (b: 0.00, p > 0.05). However, mothers’ mental health was significantly associated with their children’s academic competence in adolescence (b: 0.20, p < 0.05) and mental health at age 18 (b: 0.22, p < 0.01). These child variables significantly predict educational attainment (academic competence b: 0.54, p < 0.001, mental health b: 0.18, p < 0.05). Intragenerational Any common mental health problem Adult Isohanni et al. [ 40 ] (Good quality) People with non-psychotic disorders had increased odds of attaining basic (versus secondary or tertiary) education, whether with onset before age 22 (OR:3.2, 95% CI: 2.1, 4.7, p < 0.0001) or at age 23 or older (OR: 3.1, 95% CI: 1.9–5.3, p < 0.0001). Fewer people with age of onset before 22 attained tertiary education (4%), while more with age of onset at 23 or older attained tertiary education (18%). Any common mental health problem Childhood/Adolescence John et al. [ 41 ] (Good quality) There was an association between having a recorded mental health disorder and absenteeism (OR 2·9, 95% CI 2·8–2·9), and of the 3.7% of pupils who had been excluded once, 20.8% were reported to have a mental disorder. Pupils with depression had slightly higher odds of being absent from school. However, there was no significant association between anxiety and absenteeism. Any common mental health problem Adolescence Johnson et al. [ 42 ] (Good quality) Controlling for comorbid mental health problems, parental SES, parental psychopathology, child’s age, child’s gender and child’s intelligence quotient, a diagnosis of an anxiety disorder was associated with a reduced risk of dropping out of secondary school (OR: 0.21, 95% CI: 0.05, 0.97, p = 0.039). A diagnosis of an anxiety disorder was not significantly associated with a failure to continue education beyond secondary school (OR: 1.59, 95% CI: 0.58, 4.42, p = 0.371). Controlling for comorbid mental health problems, parental SES, parental psychopathology, child’s age, child’s gender and child’s intelligence quotient, a diagnosis of depression was associated with a reduced risk of dropping out of secondary school (OR: 0.23, 95% CI: 0.06, 0.82, p = 0.028). A diagnosis of depression was not significantly associated with a failure to continue education beyond secondary school (OR: 1.16, 95% CI: 0.43, 3.12, p = 0.769). Symptoms of Depressive and anxiety disorders Adolescence Meibner et al. [ 45 ] (Good quality) There was no significant association between individuals with ‘internalised’ mental health problems (MHP), lower levels of educational attainment (r= -0.01, p = 0.912), failure to achieve expected level of education (r = 0.09, p = 0.062), or drop out from vocational/academic training (r = 0.09, p = 0.054). Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of educational attainment (F = 0.0, p = 0.98) after controlling for parental SES. Any common mental health problem Young adult/adulthood Christensen et al. [ 33 ] (Fair quality) Individuals 16–24 years: Individuals with poor mental health were less likely to progress from basic education to short education (men: unadjusted HR: 0.72, 95% confidence interval (CI): 0.62–0.85; women: unadjusted HR: 0.87, 95% CI: 0.79–0.96). Short education to medium/long education: Women (aged 16–24 years) with poor mental health were less likely to progress from short education to medium/long education (unadjusted HR: 0.75; 95% CI: 0.62–0.90). Men with poor mental health were not significantly less likely to progress from short education to medium/long education (HR: 0.84, 95% CI: 0.61–1.17). Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) Adults with depression did not have significantly different odds of improving their educational attainment compared with controls (OR: 0.83, 95% 0.51, 1.35, p = 0.46). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Poor childhood mental health significantly predicted reduced likelihood of getting a degree after controlling for maternal mental health, maternal education and parental social class (b: -0.023, SE: 0.005, p < 0.01) Any common mental health problem Adolescence Sellers et al. [ 50 ] (Fair quality) In two different cohorts (ALSPAC and NCDS), children with mental health problems were less likely to go on to achieve a least five good exam passes than children without mental health problems (boys: NCDS: OR: 0.49, 95% CI: 0.31, 0.78, p = 0.003, ALSPAC: OR: 0.30, 95% CI: 0.22, 0.41, p < 0.001; girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p = 0.010, ALSPAC: OR: 0.34, 95% CI: 0.23, 0.50, p < 0.001) (no parental SES adjustment). Any common mental health problem Adult Slominski et al. [ 51 ] (Fair quality) Offspring mental health at age 18 was significantly associated with educational attainment at age 30 (b: 0.018, p < 0.05). Any common mental health problem Adult Abebe et al. [ 26 ] (Poor quality) In people with disability, controlling for gender and parental levels of education, poor mental health increased the chances of low levels of educational attainment (b: 0.136, SE: 0.019, p < 0.0001). Any common mental health problem Adolescence Case et al. [ 31 ] (Poor quality) Mental health or emotional problems at age 16 were associated with a reduced number of ‘O’ level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16, mental problems at age 7 (b:-0.637, SE: 0.123, p > 0.05). Mental health or emotional problems at age 7 were also associated with a reduced number of ‘O’ level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16 and mental impairments at age 16 (b: = -0.601, SE: 0.128, p > 0.05). Income Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s income (F = 0.03, p = 0.87) after controlling for parental SES. Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Worse mental health in mothers predicted reduced household income for their children at age 30 (b:-0.036, SE: 0.008, p < 0.01). When controlling for child mental health at age 10, the association of mothers’ mental health with reduced income for their children at age 30 became weaker but remained significant (b:-0.021, SE: 0.008, p < 0.05). Child and maternal mental health interacted to predict offspring income. Depressive disorders Adult Eaton et al. [ 34 ] (Poor quality) Parental depression did not predict personal income (b: -0.01, p > 0.05) when controlling for fathers’ job level or job percentile. Intragenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of income after controlling for parental SES (F = 0.95, p = 0.33). Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) People with depression had significantly reduced odds of increasing their annual income over 5 years compared with controls (OR: 0.67, 95% CI: 0.46, 0.97, p = 0.03). People with depression did not have significantly different odds of decreasing their annual income over 5 years compared with controls (OR: 1.26, 95% CI: 0.69, 2.27, p = 0.45). Depressive disorders Adult Elovainio et al. [ 35 ] (Fair quality) Income in adulthood was predicted by depressive symptoms. Lower initial levels and faster decrease over time in depressive symptoms were associated with higher income in adulthood (controlling for parental/childhood SES). Anxiety disorders Older adult Groffen et al. [ 38 ] (Fair quality) Older adults with a social anxiety disorder had increased odds of a decrease in income after adjusting for gender, age, educational attainment, baseline income and change in occupational status (OR: 1.69, 95% CI: 1.15, 2.50, p < 0.008). Social anxiety disorder was related to a decrease in income regardless of educational attainment or income levels at baseline: these variables did not moderate the association (p = 0.68). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Childhood mental health does not predict adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.010 SE: 0.008, p > 0.05). Adulthood mental health predicts adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.083, SE: 0.008, p < 0.01). Any common mental health problem Young adult Sareen et al. [ 49 ] (Fair quality) There were no significant relationships between baseline mental health problems and change in income status during the 3-year follow-up period (statistics not reported). Depressive disorders Adult Eaton et al. [ 34 ] (Poor quality) Depression had a small negative effect on income percentile at 10-year follow-up (b:−0.10, p < 0.01). Occupation Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s occupation (F = 1.13, p = 0.29), after controlling for parental SES. Any common mental health problem Adolescence/adult Slominski et al. [ 51 ] (Fair quality) There was no direct association between mothers’ mental health and their children’s occupational status in adulthood (b: 0.08, p > 0.05). However, mothers’ mental health was significantly associated with their children’s mental health in adolescence (b: 0.22, p < 0.01). This child variable significantly predicts occupational status (b: 0.19, 0 0.05) when controlling for fathers’ job level or job percentile. Intragenerational Any common mental health problem Adult Butterworth et al. [ 30 ] (Good quality) Men with poor mental health were significantly more likely to become unemployed (b: 0.21, SE: 0.04, p < 0.001), and be unemployed for longer (b: 0.14, SE: 0.04 p < 0.05) compared with men with better mental health. Women with poor mental health are significantly more likely to become unemployed (b: 0.14, SE: 0.03, p 0.05) Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of occupation after controlling for parental SES (F = 1.07, p = 0.30). Depressive disorders Adult Amos et al. [ 27 ] (Fair quality) People with treatment-resistant depression were 2.3 times more likely than employees without depressive disorders (HR: 2.29 95% CI: 1.44, 3.65, p < 0.001) to switch to COBRA status (changed occupational status with reduced hours) during follow-up. There was significant difference between cohorts for employment termination (results not shown). People with treatment-resistant depression were 1.4 times more likely than employees without depressive disorders (HR: 1.37, 95% CI: 1.11, 1.69, p = 0.004) to either switch to COBRA status or terminate employment. Depressive disorders Adult Aro et al. [ 28 ] (Fair quality) Men and women with major affective disorder had a 2.5–3.9 times and 2.8–4.2 times higher risk, respectively, of becoming unemployed than the general population. Any common mental health problem Young adult/adulthood Christensen et al. [ 33 ] (Fair quality) Individuals in employment who experience poor mental health were more likely to become unemployed than those with good mental health (adjusted for education level and long-term illness, men aged 25–44 HR:3.74, 95% CI: 2.65–3.86, women aged 25–44: 2.79, 95% CI: 2.48–3.14, men aged 45–59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45–59 HR: 3.13, 95% CI: 2.72–3.61). Individuals who are not employed with poor mental health were less likely to become employed (adjusted for education level, long term illness, smoking behaviour, alcohol consumption, BMI, physical activity, men aged 25–44 HR: 0.56, 95% CI: 0.44–0.72, women aged 25–44 HR: 0.47, 95% CI: 0.39–0.58, men aged 45–59 HR: 0.50, 95% CI:0.38–0.67, women aged 45–59 HR: 0.43, 95% CI: 0.32, 0.59). Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) People with depression had significantly reduced odds of being employed in the previous year compared with controls (OR: 0.57, 95% CI: 0.39, 0.84, p = 0.004). People with depression had significantly reduced odds of improving their occupation over their lifetime best in the previous 5 years compared with controls (prevalence ratio [PR]: 0.45, 95% CI: 0.29, 0.69, p < 0.0001). People with depression had significantly increased odds of decreasing their occupational status from their lifetime best in the previous 5 years compared with controls (OR: 1.89, 95% CI: 1.31, 2.73, p = 0.001). Depressive disorders Adult Elovainio et al. [ 35 ] (Fair quality) Occupational status in adulthood was predicted by depressive symptoms. Lower initial levels and faster decrease over time in depressive symptoms were associated with higher occupational status in adulthood (controlling for parental/childhood SES). Any common mental health problem Adolescence/Adult Halonen et al. [ 39 ] (Fair quality) Symptoms of mental health problems were not associated with increased odds of becoming employed at a different age, controlling for parental education and household income, compared with age > 24: being age 19–23: OR: 1.01 95% CI: 0.84, 1.23, p = 0.919), being age < 18: OR: 0.76 95% CI: 0.61, 0.95, p = 0.015) Symptoms of mental health problems were also not associated with a specific occupational class obtained during first employment. Low occupational class compared with intermediate: OR: 0.95 95% CI: 0.74, 1.22, p = 0.688); non-specified compared with intermediate: OR: 0.93 95% CI: 0.73, 1.20, p = 0.567). Any common mental health problem Adult Slominski et al. [ 51 ] (Fair quality) Offspring mental health at age 18 significantly predicted occupational status at age 30 (b: 0.19, p < 0.05). Any common mental health problem Adult Tolman et al. [ 52 ] (Fair quality) Symptoms of social anxiety disorder in the preceding month significantly predicted the number of months worked (b:-0.114 SE: 0.054, p 0.05). Any common mental health problem Adult Abebe et al. [ 26 ] (Poor quality) In people with a physical disability, controlling for gender and parental education, poor mental health increased the chances of unemployment (b: 0.067, SE: 0.007, p 0.05, data not shown) Depressive disorders Adult Landstedt et al. [ 44 ] (poor quality) Depressive symptoms did not predict employment trajectories after controlling for occupational status. Men: ‘medium’ c education into stable employment: OR: 0.44 95% CI: 0.18, 1.10, p = 0.075; ‘short’ education into stable employment OR: 0.85 95% CI: 0.38, 1.90, p = 0.692; continuously unstable situation: OR: 2.20 95% CI: 0.90, 5.46, p = 0.086. Women: ‘short’ education into stable employment OR: 1.69 95% CI: 0.66, 4.38, p = 0.277; continuously unstable situation: OR: 1.92 95% CI: 0.64, 5.80, p = 0.246. Depressive disorders Adult Prause et al. [ 46 ] (poor quality) More severe depression was not associated with decreased odds of employment 2 years later in those who were unemployed at baseline (OR: 1.04, p > 0.05), and in those who were underemployed at baseline (OR: 1.04, p > 0.05). The gap between employment rates of men and women did however decrease with increasing symptoms of depression. Social mobility Intragenerational Any common mental health problem Adult Birtchnell [ 29 ] (Poor quality) People with depression showed significantly less upward social mobility (change in social class from parents) than people without depression in classes IV and V. a High−risk sample b Anxiety or depressive disorders c ’Medium’ and ‘short’ not defined by the study 3.2.1 The association between CMDs and education Intergenerational (Education) Six studies investigated the association between parental mental health and the educational attainment of their child. One good quality study [ 48 ] reported that parental depression was not a significant predictor of a child’s education after controlling for parental socio-economic status (F = 0, p = 0.97). Three fair quality studies [ 36 , 43 , 51 ] reported no direct intergenerational association between mental health and educational outcomes in children. Findings showed that once the child’s mental health was taken into account, maternal mental health did not predict educational attainment in their children by age 30 (b=-0.007, Standard error (SE): 0.005, p > 0.05) [ 43 ]. However another study reported some evidence to show that negative parent-child interactions of the mother (b:-0.01, SE: 0.002, p < .01) and father (b:0.008, SE:0.003, p < 0.01) mediated the association between parental mental health and educational attainment [ 47 ]. Additionally, maternal health was associated with academic competence (b:-0.01, SE: 0.002, p < 0.001) [ 51 ], and the odds of high school dropout increased in sons when maternal depression was considered with poverty [ 36 ]. Only one study of fair quality [ 37 ] reported that parental mental health significantly predicted a slightly slower rate of change in maths attainment between the ages of 7 to 16 (b=-0.004, 95% CI: -0.008, -0.00, p = 0.036), with an increase in symptoms linked to a decreased growth in maths attainment per year. Intragenerational (Education) Twelve studies investigated the association between an individual’s mental health and their educational attainment. Five studies of good quality evidence reported mixed findings. One study [ 42 ] reported that the risk of high school dropout was lower in those with anxiety and depression (OR: 0.21, 95% CI: 0.05, 0.97, p = 0.039). Although a diagnosis of depression was not associated with failure to continue with education beyond high school (OR: 1.16, 95%, CI: 0.06, 0.82, p = 0.028) [ 42 ]. Another study [ 41 ] reported that mental health disorders were associated with absenteeism (OR: 2.9, 95% CI: 2.8–2.9). Considering this association by sex, boys with depression were more likely to be absent from school compared with girls (OR: 0.8, CI: 0.8, 0.9, p < 0.0001); this was not the case with anxiety disorders (OR: 1.0, CI: 0.9, 1.0, p = 0.072) [ 41 ]. Boys with anxiety (OR: 2.0, CI: 1.8, 2.2, p < 0.0001) or depressive disorders (OR: 1.9 CI: 1.7, 2.1, p < 0.0001) were more likely to be excluded compared with girls [ 41 ]. Considering academic achievements, one study [ 40 ] reported that patients with nonpsychotic disorders before the age of 22 had increased odds (triple) of achieving just basic education, compared with secondary or tertiary education (OR:3.2, 95%, CI:2.1, 4.7, p < 0.0001), and compared with individuals experiencing onset age 23 or older (OR:3.1, 95% CI: 1.9–5.3, p < .00001). Contrary to the evidence identified so far, two studies of good quality, did not find an association. One study reported that depression was not a significant predictor of educational attainment (F = 0.0, p = 0.98) [ 48 ] and another [ 45 ] found no significant association between individuals with ‘internalised’ mental health problems (MHP), lower levels of educational attainment (r= -0.01, p = 0.912), failure to achieve expected level of education (r = 0.09, p = 0.062), or drop out from vocational/academic training (r = 0.09, p = 0.054) [ 45 ]. However, further analyses showed that there was an association by age on ‘internalised’ MHP and attaining lower levels of education (b = − 0.13, Wald X²(1,N = 433) = 4.19, p = 0.041) [ 45 ]. Three fair quality studies reported an association between poor mental health and educational attainment. Individuals with poor mental health were less likely to progress from basic education (primary school), to short-term education (upper secondary/vocational school) (men: unadjusted Hazard Ratio (HR): 0.72, 95% confidence interval (CI): 0.62–0.85; women: unadjusted HR: 0.87, 95% CI: 0.79–0.96) [ 33 ]. Furthermore, women with poor mental health were less likely to progress from short-term to medium/long-term education (unadjusted HR: 0.75; 95% CI: 0.62–0.90) [ 33 ]. Poor childhood mental health reduced the likelihood of getting a degree (b:-0.023, SE: 0.005, p < 0.01) [ 43 ], and mental health issues at 18 were significantly associated with educational attainment by age 30 (b: 0.018, p < 0.05) [ 51 ]. Additionally, children with poor mental health were less likely to achieve five good exam passes compared with children without (Boys: National Child Development Study (NCDS): Odds ratio (OR): 0.49, 95% CI: 0.31, 0.78, p = 0.003 Avon Longitudinal Study of Parents and Children (ALSPAC) OR: 0.30, 95% CI: 0.22, 0.41, p < 0.001, Girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p = 0.010, ALSPAC: OR:b + 0.34, 95% CI: 0.23, 0.50, p < 0.001) [ 50 ]. However, one study of fair quality [ 32 ] did not find an association between adults with depression and in those without, on improving their educational status over a 5-year period (OR: 0.83, 95% 0.51, 1.35, p = 0.46) [ 32 ]. Two studies of poor quality [ 26 , 31 ] reported on the association between childhood mental health and achievements in secondary level education. Those aged 7 and 16 with mental health problems were more likely to achieve a reduced level of O-level passes (b:-0.637, SE:0.123, p > .05) [ 31 ]. Finally, young people with depression and/or an anxiety disorder and a physical disability were more likely to achieve low levels of secondary education (b:0.136, SE:0.019, p < 0.0001) (b:0.136, SE:0.019, p < 0.0001) [ 26 ]. Summary (Education) The evidence suggests that parental mental health is not directly associated with their child’s education. However, when mediating factors are considered, such as parent-child interactions, parental mental health is associated with their child’s educational outcomes and progression. The evidence for the association between a person’s own mental health and educational outcomes varied, but there was some evidence that experiencing poor mental health at a younger age was more likely to be associated with poorer educational outcomes. The findings provide some insight into CMDs and how individuals progress through education. 3.2.2 The association between CMDs and income Intergenerational (Income) Three studies (one good quality [ 48 ], one fair quality [ 43 ] and one poor quality [ 34 ]) investigated the intergenerational association of CMDs on income. Two of the studies reported that parental CMDs (depressive disorders) were not a predictor of their children’s income (F = 0.03, p = 0.87) [ 48 ], (b: -0.01, p > 0.05) [ 34 ]. However, one fair quality study [ 43 ] reported that maternal CMDs (anxiety and depression) predicted a reduced household income for children at age 30 (b: -0.036, SE: 0.008, p < 0.01). Intragenerational (Income) Seven studies considered the intragenerational association of CMDs on income. One good quality study [ 48 ] reported that depression was not a significant predictor of income (F = 0.95, p = 0.33). Five fair quality studies reported mixed results. One study [ 38 ] reported that social anxiety increased the odds of a decreased income in adults (O: 1.69, 95% CI:1.15, 2.50, p < 0.008). Considering depressive disorders, one study [ 32 ] reported that patients with depression had reduced odds of increasing their annual income (OR: 0.67, 95% CI: 0.46, 0.97, p = 0.03), but did not significantly differ in odds of decreasing their annual income over a 5-year period (OR: 1.26, 95% CI: 0.69, 2.27, p = 0.45). Another study [ 43 , 49 ] reported that childhood mental health problems (anxiety and depression) did not predict adult income (b:-0.010 SE: 0.008, p > 0.05), though adult mental health predicted adult income (b:-0.083, SE: 0.008, p < 0.01). Furthermore, one study reported that depressive symptoms predicted adulthood income, with lower initial levels of depression and a faster decrease in symptoms associated with higher income in adulthood [ 35 ]. One study reported on young adults and found that over a 3-year period, there was no significant association between baseline mental health problems and income [ 49 ]. A study of poor quality study [ 34 ] reported that at 10-year follow-up, there was a small negative association between depression in adulthood and income percentile (b:-0.10, p < 0.01). Summary (Income) The evidence shows that parental mental health problems/CMDs may have a limited association on their child’s income. The evidence for the association between one’s own mental health and income outcomes were varied. However, a key finding of the evidence that reported an association is that income was more likely to be affected in individuals who have experienced a CMD in later adulthood. 3.2.3 The association between CMDs and occupation Intergenerational (Occupation) Three studies (one of good quality [ 48 ], and two of fair quality [ 51 , 52 ]) investigated the association between parental CMDs and their child’s occupation. Parental depression was not associated with their children’s occupation (F = 1.13, p = 0.29) [ 48 ], even after controlling for the father’s job level (b:0.00, p > 0.05) [ 52 ]. One study reported that there was no association between the mental health of mothers and their children’s occupational status (b:0.08, p > 0.05) [ 51 ]. However, maternal mental health was associated with adolescent mental health (b:0.22, p < 0.01), which predicted occupational attainment (b:0.19, p < 0.05) [ 51 ]. Intragenerational (Occupation) Fourteen studies investigated the intragenerational association between mental health and occupation. One study of good quality [ 30 ] reported that men with depressive and anxiety disorders were more likely to become unemployed and be unemployed for longer compared with men with better mental health. Women were also more likely to become unemployed but were not more likely to be unemployed for longer [ 30 ]. However, another good quality study [ 48 ] did not find any association in young adults (F = 1.07, p = 0.30). Three studies of fair quality reported a significant association between mental health conditions and occupational status. Adulthood occupational status was predicted by depressive symptoms, as lower initial levels and faster decrease in symptoms over time were associated with higher occupational status [ 35 ]. Also, occupational status at age 30 was predicted by mental health at age 18 (b: 0.19, p < 0.05) [ 51 ]. Considering this association further, patients with depression, (compared with controls) had reduced odds of being employed in the previous year of the study (OR: 0.57, 95% CI: 0.39, 0.84, p = 0.004), had reduced odds of improving their occupation over their lifetime best in the last 5 years (OR: 0.45, 95% CI:0.29, 0.69, p < .0001), and had increased odds of decreasing their occupational status from their lifetime best over a 5-year period (OR: 1.89, 95% CI:1.31, 2.72, p = .001) [ 32 ]. Five fair quality studies reported on the association of mental health problems and employment. Social anxiety predicted the number of months worked (b:-0.114 SE: 0.054, p .05) [ 52 ]. Another study [ 39 ] reported that symptoms of depression and anxiety increased the odds of being employed before 18 years (those above 24 years compared with 19–23 years: OR: 1.01, 95% CI: 0.84, 1.23, p = 0.919, versus those below 18 years: OR: 0.76, 95% CI: 0.61, 0.95, p = 0.015). One study reported [ 28 ] that men and women with major affective disorder had a higher risk (men: 2.5–3.9 times and women: 2.8–4.2 times higher risk) of becoming unemployed than the general population. Another study [ 27 ] reported that employees with treatment-resistant depression (TRD) were more likely to switch to working fewer hours during follow up (Consolidated Omnibus Budget Reconciliation [COBRA] status) (HR: 2.29 95% CI:1.44, 3.65, p < 0.001), or stopped employment (HR: 1.37, 95% CI:1.11, 1.69, p = 0.004), than employees without depression. Finally, one [ 33 ] study reported that Individuals with poor mental health were more likely to become unemployed (men aged 25–44: HR:3.74, 95% CI: 2.65–3.86, women aged 25–44: 2.79, 95% CI: 2.48–3.14, men aged 45–59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45–59 HR: 3.13, 95% CI: 2.72–3.61). More specifically, individuals with poor mental health were less likely to take on employment compared with unemployed individuals with good mental health (men aged 25–44 HR: 0.56, 95% CI: 0.44–0.72, women aged 25–44 HR: 0.47, 95% CI: 0.39–0.58, men aged 45–59 HR: 0.50, 95% CI:0.38–0.67, women aged 45–59 HR: 0.43, 95% CI: 0.32, 0.59). Three poor quality studies did not find a significant association between mental health problems and changes in occupational status. An individual’s employment trajectory and depressive symptoms were not associated [ 44 ], and depressive symptoms at baseline did not predict job percentile (b: 0.067, SE: 0.007, p 0.05) [ 46 ]. However, an additional poor quality study did report that in patients with a physical disability, symptoms of anxiety and depression increased chances of unemployment (b: 0.067, SE: 0.007, p < 0.0001) [ 26 ]. Summary (occupation) Most studies did not investigate the intergenerational association, however the few studies that did find some evidence, suggested that parental CMDs are associated with their child’s CMD and subsequently their occupational status. Findings for the effect of a person’s CMD on employment outcomes were mixed, although a number of fair quality studies reported an association between an individual’s mental health, occupational status, and employment status. In view of all the (limited) evidence, CMDs may be associated with unemployment status. 3.2.4 The association between CMDs and social mobility Intergenerational (social mobility) One study (poor quality) [ 29 ] examined the direct measure of social mobility by assessing the change in social class of patients with mental health disorders to that of their parents. Patients with depression showed less upward social mobility (change in social class from parents) than people without depression in classes IV (partly skilled occupations[ 53 ]) and V (unskilled occupations [ 53 ]). 4. Discussion Overall, there is more evidence to suggest that there is a negative association between a person’s own experience (intragenerational) of a CMD, and their ability to improve their socioeconomic outcomes and social mobility within their own lifetime [ 29 , 47 ], compared with the intergenerational effects of CMDs [ 26 – 28 , 30 – 32 , 35 , 38 , 40 , 43 , 50 , 51 ]. Evidence from this review reinforces the significance of both the social selection and the health selection theory [ 1 – 3 ]. The evidence also highlights the necessity of policies that support the implementation of interventions that adequately equip individuals to maintain their own mental health, with the wider goal of improving their socioeconomic outcomes and therefore their upwards social mobility. Despite the association between CMDs, socioeconomic outcomes and social mobility, there were some studies that showed no association at all [ 39 , 46 , 48 ]. This variation in findings may have occurred due to the different measures used to identify those with a CMD. Although a number of studies used official diagnostic tools to measure symptoms of CMDs, participants presented with symptoms varying in severity. As a result, whilst all participants would have experienced some symptoms, only some participants presented with symptoms severe enough to receive a formal diagnosis. Therefore, the association between clinically diagnosed CMDs and socioeconomic outcomes may be underestimated. There was some association between occupation and income level with the duration of illness (depression), severity of illness, and treatment resistant depression [ 27 , 35 ]. It is important to understand how this affects individuals with chronic mental illness who may attain employment but experience poor work progression [ 27 , 35 ], considering that maintaining employment is often regarded as a key outcome of treatment of people experiencing a mental health disorder [ 54 , 55 ]. Individuals who experience lower symptom severity and faster recovery earlier on in illness are not as affected, achieving a higher occupational status [ 27 , 35 ]. This reinforces the importance of early intervention services to quickly identify and treat CMD symptoms before they have a more detrimental impact. This will enable individuals to have an equal opportunity to experience upwards social mobility, and improve employment prospects, despite the initial negative impact a CMD may have. Studies reported a negative association between an individual’s own mental health and educational outcomes [ 26 , 31 , 40 , 43 , 50 , 51 ], but there was a weak association between parental mental health and their child’s educational outcomes [ 47 ]. However, there are mediating factors that explain how parental mental health problems may be associated with a child’s mental health and therefore their educational attainment. One factor included parent-child interactions [ 47 ]. Research has shown that interventions that target how mothers with CMDs perceive and interact with their children, results in mothers having a positive view of their children [ 56 ]. This leads to improved parent-child interactions and better social mobility outcomes for the child [ 47 , 56 ]. Therefore, a healthy parent-child relationship may be a protective factor, which can counteract the negative association between one’s own mental health and subsequent educational outcomes. A range of studies highlighted the negative impact that experiencing a CMD at a younger age has on education [ 40 , 43 , 51 ]. Early age onset of CMDs are associated with chronic mental illness [ 57 – 59 ], but despite this association, the effects and prevalence rates of CMDs are under investigated in adolescent groups globally [ 60 ]. Furthermore, the number of young people accessing child and adolescent mental health services is significantly lower than the overall prevalence rate [ 59 ]. There is a clear need for further research into the burden of adolescent mental disorders, and for alternative mental health interventions that extend into environments that affect the lives of young people, such as the education system at secondary and university level, to be established. Generally research has shown positive effects of various interventions on academic achievement and school grades [ 61 ]. One study evaluated the effects of a school-based intervention on student’s mental health [ 62 ]. Results showed that a decrease in symptoms of anxiety and depression were associated with an increase in self-esteem. High self-esteem has been linked with increased academic performance [ 63 ]. Based on this evidence, and with the increased pressure on community health teams, future research investigating school-based interventions and implementing policies to mitigate the negative impact of CMDs highlighted in this review, are of high importance. Although few studies focused on the impact of anxiety on income, education and occupation, two studies did report a negative association. Both studies found that social anxiety increased the likelihood of an individual experiencing a decrease in income, and working fewer hours [ 38 , 52 ]. Symptoms of social anxiety include embarrassment or fear of social situations [ 64 ]. These symptoms can have a detrimental impact on an individual’s ability to function in the work environment where they may experience fear of speaking in front small groups, leading to fewer opportunities at work [ 65 ] [ 66 ]. Providing adjustments within the work environment for individuals with social anxiety could increase efficiencies and reduce the financial burden to the individual and society as a result of social anxiety. 5. Limitations There are a number of limitations to note. Although socioeconomic factors have been widely investigated, only one study reported on direct measures of social mobility. More high quality research using clearly defined social mobility measures, such as change in social class, should be conducted. This will enable policies to be developed around mental health interventions most needed in society, combat long-term unemployment, and improve employment prospects and income for people with CMDs [ 67 , 68 ]. The literature in this review included notably fewer studies on anxiety disorders. Anxiety disorders are amongst the most common mental disorders [ 59 , 69 ], and can cause particularly adverse consequences in women, young adults and individuals from some minoritised ethnic groups [ 69 ]. Although the studies included in the current review had good representation for both men, women and young adults, individuals from minoritised ethnic groups were seldom included. This is particularly important as some individuals from minoritised ethnic groups are more likely to experience unique life stressors, anxiety around discrimination and racism [ 70 ] and misconceptions about immigration [ 71 ]. This may potentially hinder upwards social mobility in ways not observed in other ethnic groups that have been widely investigated. 6. Conclusion In conclusion, there is more evidence to suggest a negative intragenerational (than intergenerational) association between CMDs, reduced educational attainment, occupational status, and income. This highlights the need to further adapt mental health interventions into work and school environments, to equip individuals to take care of their own mental health, where community based health team may be limited. However, it is still important to understand how relationships in families, where parents are experiencing symptoms of mental health disorders may impact children, and provide additional support to mitigate the potential impact on social mobility. Future research investigations should focus on investigating CMDs and direct measures of social mobility such as social class. 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(2016) A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and Behavior. 6(7): p. e00497. Wallace, S., J. Nazroo, and L. Becares (2016) Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. American journal of public health. 106(7): p. 1294–300. Valentin-Cortes, M., et al. (2020) Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants. American Journal of Community Psychology. 66(3–4): p. 325–336. Unsectioned Paragraphs ORCID ID: 0000-0002-1206-1519 Word count: 4436 Declarations of interest : None. Table 1 Characteristics of included studies Table 2: The association between common mental health disorders, socioeconomic outcomes, and social mobility a High−risk sample b Anxiety or depressive disorders c ’Medium’ and ‘short’ not defined by the study Fig. 1 PRISMA Diagram Fig. 1 PRISMA Diagram. Studies that were included were conducted in various countries (Norway K = 1, USA K = 10, Finland K = 4, UK K = 6, Australia K = 1, Denmark K = 1, Netherlands K = 1, Wales K = 1, Sweden K = 1, Germany K = 1). The quality of the evidence identified also varied, 6 studies rated as good quality, 15 studies rated as fair quality, and 6 studies rated as poor quality. Table 1 provides a characteristics summary of each included study a High−risk sample b Anxiety or depressive disorders c ’Medium’ and ‘short’ not defined by the study Unsectioned Tables Study reference Country (region) Sample size Study design Exposure Comparison Diagnostic criteria Mean age (range) Gender (% female) Ethnicity Follow-up Study quality Abebe et al. [ 26 ] Norway 12,287 Prospective cohort Mental health problems and a physical disability No mental health problems and a physical disability Not reported (NR) 28.5 (not recorded [NR]) 55.1 NR 13 years Poor quality (5) Amos et al. [ 27 ] US 39,479 Retrospective cohort Treatment-resistant depressive disorder No depressive disorder ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) NR (18–64) 64.2 NR 6 years Fair quality (6) Aro et al. [ 28 ] Finland 6,521 Retrospective cohort Major affective disorder No major affective disorder ICD-9 (Finnish version). which has adapted DSM-III-R criteria for mental disorders NR 55.5 NR 17 years Fair quality (6) Birtchnell [ 29 ] UK (Aberdeen) 4,159 Prospective cohort Depressive disorder No depressive disorder ICD-7 NR 0.0 NR Multiple Poor quality (4) Butterworth et al. [ 30 ] Australia (Melbourne) 13,969 Prospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR 35.85 (NR) 54.1 NR 5 years Good quality (7) Case et al. [ 31 ] UK 17,409 Prospective cohort Mental health and emotional problems No mental health and emotional problems NR NR NR NR 42 years Poor quality (4) Coryell et al. [ 32 ] US (Boston MA, Chicago IL, Iowa City IA, New York NY, St Louis MO) 480 Prospective cohort Depressive disorder No depressive disorder Research diagnostic criteria 39.15 (NR) 67.5 NR 6 years Fair quality (6) Christensen et al. [ 33 ] Denmark 108,102 Prospective Cohort Mental health problems (various) No mental health problems (various) NR 16–24 (education) 25–59 (employment) 46 NR education: 5 years employment: 4 years Fair quality (6) Eaton et al. [ 34 ] US (Baltimore MD) 907 Prospective cohort Depression disorder No depressive disorder NR 43.2 (NR) 55.1 NR 16 years Poor quality (3) Elovainio et al. [ 35 ] Finland 3,596 Prospective cohort Depressive disorder No depressive disorder NR 10.4 (NR) 53.8 NR 27 years Fair quality (4) Ensminger et al. [ 36 ] US (Chicago IL) 1,242 Prospective cohort Psychological distress No psychological distress Composite International Diagnostic Interview (CIDI) (Michigan version) according to the criteria of DSM-III-R NR NR NR NR Fair quality (5) Evans et al. [ 37 ] UK 7465 Retrospective cohort Parental postnatal mental health- Anxiety + Depression No parental mental health problems (less) NR NR NR NR Educational attainment at age 11, and rate of change in attainment age 7–16 Fair quality (6) Groffen et al. [ 38 ] Netherlands (Eindhoven) 4,745 Prospective cohort Social anxiety disorder No social anxiety disorder NR 68.9 (NR) 47.8 NR 3 years Fair quality (4) Halonen et al. [ 39 ] Finland (Northern Finland) 9,432 Retrospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR NR 50.0 NR 30 years Fair quality (5) Isohanni et al. [ 40 ] Finland (Northern Finland) 11,017 Prospective cohort Non-psychotic disorder No non-psychotic disorder DSM-III-R NR 49.0 NR NR Good quality (7) John et al. [ 41 ] Wales 437 412 Retrospective cohort Mental Disorders No mental health disorders Code lists adapted from ICD (version 10) for secondary care and read codes (version 2) 22 in primary care 10.5 (7–16) 48.9 NR 1–4 years Good quality (7) Johnson et al. [ 42 ] US (New York NY) 736 Prospective Cohort Anxiety and depressive disorders No anxiety or depressive disorders Diagnostic Interview Schedule for Children (DISC-I) 22.5 (NR) 51.0 White: 91% 19 years Good quality (5) Johnston et al. [ 43 ] UK (UK-wide) 8,496 Retrospective cohort Anxiety and depressive disorders No anxiety or depressive disorders NR NR 53.0 British: 100% 34 years Fair quality (4) Landstedt et al. [ 44 ] Sweden (North Sweden) 1,083 Retrospective cohort Depressive disorder No depressive disorder NR 42 (NR) 48.5 NR 26 years Poor quality (4) Meibner et al. [ 45 ] Germany 433 Prospective cohort Internalising Mental Health Problems (MHP) (inwards-oriented symptoms of anxiety, depression, and social difficulties) No internalizing MHP Emotional Symptoms Peer subscales adapted for internalised mental health problems score 14.88 (11.01–17.98) 54.7 6.7% two-sided migration background 6 years Good quality (6) Prause et al. [ 46 ] US 1,160 Retrospective cohort Depressive disorder No depressive disorder NR 33.2 (NR) NR NR 2 years Poor quality (3) Psychogiou et al. [ 47 ] UK (Avon) 13,988 Prospective cohort Depressive disorder No depressive disorder NR NR 48.6 NR 16 years Fair quality (5) Ritsher et al. [ 48 ] US (New Haven CT) 756 Retrospective cohort Depressive disorder No depressive disorder Diagnostic interview schedule for affective disorders and schizophrenia 25 (18–49) NR NR 17 years Good quality (5) Sareen et al. [ 49 ] US 34,653 Prospective cohort Mental health problems No mental health problems Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV NR NR NR 3 years Fair quality (4) Sellers et al. [ 50 ] UK 35,924 Prospective cohort Child mental health problems No child mental health problems NR NR 48.5 NR 9 years Fair quality (4) Slominski et al. [ 51 ] US 196 Retrospective cohort Mental health problems No mental health problems DSM structured psychiatric interview NR 55.0 European American: 63% African American: 34% Puerto Rican: 3% 3–30 years Fair quality (5) Tolman et al. [ 52 ] US (Michigan) 753 Prospective cohort Social anxiety disorder or major depressive disorder No mental health problem NR NR 100.0 Black: 56% White: 45% 1 year Fair quality (4) Outcome Intragenerational/ intergenerational Mental health problem Age Study (quality) Findings Educational attainment Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s educational attainment after controlling for parental SES (f ratio [F] = 0, p = 0.97) Any common mental health problem b Adolescence Ensminger et al. [ 36 ] (Fair quality) Mothers’ distress during either their children’s childhood or adolescence did not significantly increase the odds of secondary school drop out in either sons (OR: 1.22, 95% CI: 0.72, 2.06, p = 0.458) or daughters (OR: 0.94, 95% CI: 0.55, 1.63, p = 0.823) when controlling for maternal educational attainment. Mothers’ distress during their children’s childhood and adolescence significantly increased the odds of secondary school drop out in sons (OR: 2.29, 95% CI: 1.20, 4.37, p = 0.012) but not in daughters (OR: 1.12, 95% CI: 0.50, 2.49, p = 0.782) when controlling for maternal educational attainment. There was a significant interaction between maternal distress and poverty: maternal distress at only one time point, when combined with poverty, did significantly increase the odds of school drop out in sons only (OR: 3.07, 95% CI: 1.02, 9.22, p = 0.046). Depressive and Anxiety disorders Childhood/Adolescence Evans et al. [ 37 ] (Fair quality) From ages 7–16, parental mental health (composite score measured 1–2 years after birth) was associated with a slightly slower rate of change in maths attainment (b=-0.004, 95% CI: -0.008, -0.00, p = 0.036). An increase in mental health symptoms (by 1-unit) was associated with a decrease in maths attainment improvement per year by − 0.004 levels. At age 11, parental mental health did not predict maths attainment (b=-0.019, 95% CI: -0.037, 0.000, p = 0.053). (Controlled for: Parental education, IQ, Working memory, at home teaching, involvement and interaction of parent, sex). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Worse mental health in mothers predicted reduced chances of their children gaining a degree by age 30 (b: -0.014, SE: 0.005, p 0.05). Children’s mental health mediated the effect of their mothers’ mental health and their own educational attainment. Depressive disorders Adolescence Psychogiou et al. [ 47 ] (Fair quality) More severe depression in mothers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative mother-child relationships (b:-0.01. SE:0.002, p < 0.001) and prior educational attainment (b:-0.004, SE: 0.001, p < 0.01). More severe depression in fathers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative father-child relationships (b: 0.008, SE: 0.003, p < 0.01). Any common mental health problem Adolescence/adult Slominski et al. [ 51 ] (Fair quality) There was no direct association between mothers’ mental health and their children’s educational attainment in adulthood (b: 0.00, p > 0.05). However, mothers’ mental health was significantly associated with their children’s academic competence in adolescence (b: 0.20, p < 0.05) and mental health at age 18 (b: 0.22, p < 0.01). These child variables significantly predict educational attainment (academic competence b: 0.54, p < 0.001, mental health b: 0.18, p < 0.05). Intragenerational Any common mental health problem Adult Isohanni et al. [ 40 ] (Good quality) People with non-psychotic disorders had increased odds of attaining basic (versus secondary or tertiary) education, whether with onset before age 22 (OR:3.2, 95% CI: 2.1, 4.7, p < 0.0001) or at age 23 or older (OR: 3.1, 95% CI: 1.9–5.3, p < 0.0001). Fewer people with age of onset before 22 attained tertiary education (4%), while more with age of onset at 23 or older attained tertiary education (18%). Any common mental health problem Childhood/Adolescence John et al. [ 41 ] (Good quality) There was an association between having a recorded mental health disorder and absenteeism (OR 2·9, 95% CI 2·8–2·9), and of the 3.7% of pupils who had been excluded once, 20.8% were reported to have a mental disorder. Pupils with depression had slightly higher odds of being absent from school. However, there was no significant association between anxiety and absenteeism. Any common mental health problem Adolescence Johnson et al. [ 42 ] (Good quality) Controlling for comorbid mental health problems, parental SES, parental psychopathology, child’s age, child’s gender and child’s intelligence quotient, a diagnosis of an anxiety disorder was associated with a reduced risk of dropping out of secondary school (OR: 0.21, 95% CI: 0.05, 0.97, p = 0.039). A diagnosis of an anxiety disorder was not significantly associated with a failure to continue education beyond secondary school (OR: 1.59, 95% CI: 0.58, 4.42, p = 0.371). Controlling for comorbid mental health problems, parental SES, parental psychopathology, child’s age, child’s gender and child’s intelligence quotient, a diagnosis of depression was associated with a reduced risk of dropping out of secondary school (OR: 0.23, 95% CI: 0.06, 0.82, p = 0.028). A diagnosis of depression was not significantly associated with a failure to continue education beyond secondary school (OR: 1.16, 95% CI: 0.43, 3.12, p = 0.769). Symptoms of Depressive and anxiety disorders Adolescence Meibner et al. [ 45 ] (Good quality) There was no significant association between individuals with ‘internalised’ mental health problems (MHP), lower levels of educational attainment (r= -0.01, p = 0.912), failure to achieve expected level of education (r = 0.09, p = 0.062), or drop out from vocational/academic training (r = 0.09, p = 0.054). Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of educational attainment (F = 0.0, p = 0.98) after controlling for parental SES. Any common mental health problem Young adult/adulthood Christensen et al. [ 33 ] (Fair quality) Individuals 16–24 years: Individuals with poor mental health were less likely to progress from basic education to short education (men: unadjusted HR: 0.72, 95% confidence interval (CI): 0.62–0.85; women: unadjusted HR: 0.87, 95% CI: 0.79–0.96). Short education to medium/long education: Women (aged 16–24 years) with poor mental health were less likely to progress from short education to medium/long education (unadjusted HR: 0.75; 95% CI: 0.62–0.90). Men with poor mental health were not significantly less likely to progress from short education to medium/long education (HR: 0.84, 95% CI: 0.61–1.17). Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) Adults with depression did not have significantly different odds of improving their educational attainment compared with controls (OR: 0.83, 95% 0.51, 1.35, p = 0.46). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Poor childhood mental health significantly predicted reduced likelihood of getting a degree after controlling for maternal mental health, maternal education and parental social class (b: -0.023, SE: 0.005, p < 0.01) Any common mental health problem Adolescence Sellers et al. [ 50 ] (Fair quality) In two different cohorts (ALSPAC and NCDS), children with mental health problems were less likely to go on to achieve a least five good exam passes than children without mental health problems (boys: NCDS: OR: 0.49, 95% CI: 0.31, 0.78, p = 0.003, ALSPAC: OR: 0.30, 95% CI: 0.22, 0.41, p < 0.001; girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p = 0.010, ALSPAC: OR: 0.34, 95% CI: 0.23, 0.50, p < 0.001) (no parental SES adjustment). Any common mental health problem Adult Slominski et al. [ 51 ] (Fair quality) Offspring mental health at age 18 was significantly associated with educational attainment at age 30 (b: 0.018, p < 0.05) Any common mental health problem Adult Abebe et al. [ 26 ] (Poor quality) In people with disability, controlling for gender and parental levels of education, poor mental health increased the chances of low levels of educational attainment (b: 0.136, SE: 0.019, p < 0.0001). Any common mental health problem Adolescence Case et al. [ 31 ] (Poor quality) Mental health or emotional problems at age 16 were associated with a reduced number of ‘O’ level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16, mental problems at age 7 (b:-0.637, SE: 0.123, p > 0.05). Mental health or emotional problems at age 7 were also associated with a reduced number of ‘O’ level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16 and mental impairments at age 16 (b: = -0.601, SE: 0.128, p > 0.05). Income Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s income (F = 0.03, p = 0.87) after controlling for parental SES. Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Worse mental health in mothers predicted reduced household income for their children at age 30 (b:-0.036, SE: 0.008, p < 0.01). When controlling for child mental health at age 10, the association of mothers’ mental health with reduced income for their children at age 30 became weaker but remained significant (b:-0.021, SE: 0.008, p < 0.05). Child and maternal mental health interacted to predict offspring income. Depressive disorders Adult Eaton et al. [ 34 ] (Poor quality) Parental depression did not predict personal income (b: -0.01, p > 0.05) when controlling for fathers’ job level or job percentile Intragenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of income after controlling for parental SES (F = 0.95, p = 0.33) Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) People with depression had significantly reduced odds of increasing their annual income over 5 years compared with controls (OR: 0.67, 95% CI: 0.46, 0.97, p = 0.03). People with depression did not have significantly different odds of decreasing their annual income over 5 years compared with controls (OR: 1.26, 95% CI: 0.69, 2.27, p = 0.45). Depressive disorders Adult Elovainio et al. [ 35 ] (Fair quality) Income in adulthood was predicted by depressive symptoms. Lower initial levels and faster decrease over time in depressive symptoms were associated with higher income in adulthood (controlling for parental/childhood SES). Anxiety disorders Older adult Groffen et al. [ 38 ] (Fair quality) Older adults with a social anxiety disorder had increased odds of a decrease in income after adjusting for gender, age, educational attainment, baseline income and change in occupational status (OR: 1.69, 95% CI: 1.15, 2.50, p < 0.008). Social anxiety disorder was related to a decrease in income regardless of educational attainment or income levels at baseline: these variables did not moderate the association (p = 0.68). Any common mental health problem Adult Johnston et al. [ 43 ] (Fair quality) Childhood mental health does not predict adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.010 SE: 0.008, p > 0.05). Adulthood mental health predicts adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.083, SE: 0.008, p < 0.01). Any common mental health problem Young adult Sareen et al. [ 49 ] (Fair quality) There were no significant relationships between baseline mental health problems and change in income status during the 3-year follow-up period (statistics not reported). Depressive disorders Adult Eaton et al. [ 34 ] (Poor quality) Depression had a small negative effect on income percentile at 10-year follow-up (b:−0.10, p < 0.01) Occupation Intergenerational Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Parents’ depression was not a significant predictor of their children’s occupation (F = 1.13, p = 0.29), after controlling for parental SES. Any common mental health problem Adolescence/adult Slominski et al. [ 51 ] (Fair quality) There was no direct association between mothers’ mental health and their children’s occupational status in adulthood (b: 0.08, p > 0.05). However, mothers’ mental health was significantly associated with their children’s mental health in adolescence (b: 0.22, p < 0.01). This child variable significantly predicts occupational status (b: 0.19, 0 0.05) when controlling for fathers’ job level or job percentile. Intragenerational Any common mental health problem Adult Butterworth et al. [ 30 ] (Good quality) Men with poor mental health were significantly more likely to become unemployed (b: 0.21, SE: 0.04, p < 0.001), and be unemployed for longer (b: 0.14, SE: 0.04 p < 0.05) compared with men with better mental health. Women with poor mental health are significantly more likely to become unemployed (b: 0.14, SE: 0.03, p 0.05) Depressive disorders Young adult Ritsher et al. [ 48 ] (Good quality) a Depression was not a significant predictor of occupation after controlling for parental SES (F = 1.07, p = 0.30). Depressive disorders Adult Amos et al. [ 27 ] (Fair quality) People with treatment-resistant depression were 2.3 times more likely than employees without depressive disorders (HR: 2.29 95% CI: 1.44, 3.65, p < 0.001) to switch to COBRA status (changed occupational status with reduced hours) during follow-up. There was significant difference between cohorts for employment termination (results not shown). People with treatment-resistant depression were 1.4 times more likely than employees without depressive disorders (HR: 1.37, 95% CI: 1.11, 1.69, p = 0.004) to either switch to COBRA status or terminate employment. Depressive disorders Adult Aro et al. [ 28 ] (Fair quality) Men and women with major affective disorder had a 2.5–3.9 times and 2.8–4.2 times higher risk, respectively, of becoming unemployed than the general population. Any common mental health problem Young adult/adulthood Christensen et al. [ 33 ] (Fair quality) Individuals in employment who experience poor mental health were more likely to become unemployed than those with good mental health (adjusted for education level and long-term illness, men aged 25–44 HR:3.74, 95% CI: 2.65–3.86, women aged 25–44: 2.79, 95% CI: 2.48–3.14, men aged 45–59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45–59 HR: 3.13, 95% CI: 2.72–3.61). Individuals who are not employed with poor mental health were less likely to become employed (adjusted for education level, long term illness, smoking behaviour, alcohol consumption, BMI, physical activity, men aged 25–44 HR: 0.56, 95% CI: 0.44–0.72, women aged 25–44 HR: 0.47, 95% CI: 0.39–0.58, men aged 45–59 HR: 0.50, 95% CI:0.38–0.67, women aged 45–59 HR: 0.43, 95% CI: 0.32, 0.59). Depressive disorders Adult Coryell et al. [ 32 ] (Fair quality) People with depression had significantly reduced odds of being employed in the previous year compared with controls (OR: 0.57, 95% CI: 0.39, 0.84, p = 0.004). People with depression had significantly reduced odds of improving their occupation over their lifetime best in the previous 5 years compared with controls (prevalence ratio [PR]: 0.45, 95% CI: 0.29, 0.69, p < 0.0001). People with depression had significantly increased odds of decreasing their occupational status from their lifetime best in the previous 5 years compared with controls (OR: 1.89, 95% CI: 1.31, 2.73, p = 0.001). Depressive disorders Adult Elovainio et al. [ 35 ] (Fair quality) Occupational status in adulthood was predicted by depressive symptoms. Lower initial levels and faster decrease over time in depressive symptoms were associated with higher occupational status in adulthood (controlling for parental/childhood SES). Any common mental health problem Adolescence/Adult Halonen et al. [ 39 ] (Fair quality) Symptoms of mental health problems were not associated with increased odds of becoming employed at a different age, controlling for parental education and household income, compared with age > 24: being age 19–23: OR: 1.01 95% CI: 0.84, 1.23, p = 0.919), being age < 18: OR: 0.76 95% CI: 0.61, 0.95, p = 0.015) Symptoms of mental health problems were also not associated with a specific occupational class obtained during first employment. Low occupational class compared with intermediate: OR: 0.95 95% CI: 0.74, 1.22, p = 0.688); non-specified compared with intermediate: OR: 0.93 95% CI: 0.73, 1.20, p = 0.567). Any common mental health problem Adult Slominski et al. [ 51 ] (Fair quality) Offspring mental health at age 18 significantly predicted occupational status at age 30 (b: 0.19, p < 0.05). Any common mental health problem Adult Tolman et al. [ 52 ] (Fair quality) Symptoms of social anxiety disorder in the preceding month significantly predicted the number of months worked (b:-0.114 SE: 0.054, p 0.05). Any common mental health problem Adult Abebe et al. [ 26 ] (Poor quality) In people with a physical disability, controlling for gender and parental education, poor mental health increased the chances of unemployment (b: 0.067, SE: 0.007, p 0.05, data not shown) Depressive disorders Adult Landstedt et al. [ 44 ] (poor quality) Depressive symptoms did not predict employment trajectories after controlling for occupational status. Men: ‘medium’ c education into stable employment: OR: 0.44 95% CI: 0.18, 1.10, p = 0.075; ‘short’ education into stable employment OR: 0.85 95% CI: 0.38, 1.90, p = 0.692; continuously unstable situation: OR: 2.20 95% CI: 0.90, 5.46, p = 0.086. Women: ‘short’ education into stable employment OR: 1.69 95% CI: 0.66, 4.38, p = 0.277; continuously unstable situation: OR: 1.92 95% CI: 0.64, 5.80, p = 0.246. Depressive disorders Adult Prause et al. [ 46 ] (poor quality) More severe depression was not associated with decreased odds of employment 2 years later in those who were unemployed at baseline (OR: 1.04, p > 0.05), and in those who were underemployed at baseline (OR: 1.04, p > 0.05). The gap between employment rates of men and women did however decrease with increasing symptoms of depression. Social mobility Intragenerational Any common mental health problem Adult Birtchnell [ 29 ] (Poor quality) People with depression showed significantly less upward social mobility (change in social class from parents) than people without depression in classes IV and V. Additional Declarations No competing interests reported. Supplementary Files ESM1.docx ESM2.docx ESM3.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2656092","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":258324805,"identity":"487faea1-ced1-4bad-8cd6-c47351d79db7","order_by":0,"name":"Iyinoluwa Deborah Oshinowo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYBACNiBmZjAAMZkPMDAUgAWZidXClsAAYRDQgqSCx4A4LXwMzIc/FxTckTM43vNN4ocBgzx/A4+xAX6HsaVJzzB4Zmxw5uw2yR4DBsMZB3iME/Br4TFj5jE4nLjtRu42aaDDGDcw8BgfIKDF+DNES84zkBZ7YrQYSEO1sIG0JIK04HcYM9AvQC3G9meOGVv2GEgkzzjMVozX+/LtzYc/8/w5LCfZ3vzwxo8KG9v+9ubNEvi0oMeBBDEROQpGwSgYBaOAEAAAFXM6How0WZ4AAAAASUVORK5CYII=","orcid":"","institution":"University College London","correspondingAuthor":true,"prefix":"","firstName":"Iyinoluwa","middleName":"Deborah","lastName":"Oshinowo","suffix":""},{"id":258324806,"identity":"863af3e4-4f8a-4b0c-b260-76ac5edce7bf","order_by":1,"name":"Phoebe Barnett","email":"","orcid":"","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Phoebe","middleName":"","lastName":"Barnett","suffix":""},{"id":258324808,"identity":"84c3af6b-eff9-4088-9c9d-86b21bb4e0f5","order_by":2,"name":"Christopher Cooper","email":"","orcid":"","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Christopher","middleName":"","lastName":"Cooper","suffix":""},{"id":258324809,"identity":"00560562-f3dc-40c4-85e5-35d638bea4d6","order_by":3,"name":"Shubulade Smith","email":"","orcid":"","institution":"National Collaborating Centre for Mental Health, Royal College of Psychiatrists","correspondingAuthor":false,"prefix":"","firstName":"Shubulade","middleName":"","lastName":"Smith","suffix":""},{"id":258324810,"identity":"0f8e3980-e9a4-4290-9077-d3173c8bdd8a","order_by":4,"name":"Clare Taylor","email":"","orcid":"","institution":"National Collaborating Centre for Mental Health, Royal College of Psychiatrists","correspondingAuthor":false,"prefix":"","firstName":"Clare","middleName":"","lastName":"Taylor","suffix":""},{"id":258324811,"identity":"e04d3dbd-2631-474f-86d0-e1131527b970","order_by":5,"name":"Stephen Pilling","email":"","orcid":"","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Stephen","middleName":"","lastName":"Pilling","suffix":""}],"badges":[],"createdAt":"2023-03-05 01:29:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2656092/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2656092/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49495294,"identity":"bcfb4b25-8279-4e0e-b1ec-15f2b69b8f8a","added_by":"auto","created_at":"2024-01-11 19:41:44","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":566685,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA Diagram. Studies that were included were conducted in various countries (Norway K = 1, USA K = 10, Finland K = 4, UK K = 6, Australia K = 1, Denmark K = 1, Netherlands K = 1, Wales K = 1, Sweden K = 1, Germany K = 1). The quality of the evidence identified also varied, 6 studies rated as good quality, 15 studies rated as fair quality, and 6 studies rated as poor quality. Table 1 provides a characteristics summary of each included study\u003c/p\u003e","description":"","filename":"Fig.11.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2656092/v1/989f158bd5b4524dc67f5d10.jpg"},{"id":52162586,"identity":"6b2fa941-3cac-41f3-b019-ffadfb4473e8","added_by":"auto","created_at":"2024-03-07 15:08:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1018452,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2656092/v1/a6003355-0990-46c5-b882-e99edf0bb946.pdf"},{"id":49495295,"identity":"78b48b95-e6e6-431e-96c4-75ed9fca51f9","added_by":"auto","created_at":"2024-01-11 19:41:44","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":39078,"visible":true,"origin":"","legend":"","description":"","filename":"ESM1.docx","url":"https://assets-eu.researchsquare.com/files/rs-2656092/v1/7c79e547e5b1318d9b4ed56c.docx"},{"id":49495293,"identity":"7580e149-20a2-449e-9576-9adefcde604a","added_by":"auto","created_at":"2024-01-11 19:41:44","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":52541,"visible":true,"origin":"","legend":"","description":"","filename":"ESM2.docx","url":"https://assets-eu.researchsquare.com/files/rs-2656092/v1/555f02083ae651ee8d0727bf.docx"},{"id":49495296,"identity":"b9dfa485-4658-4fde-a40d-7b2ec042156e","added_by":"auto","created_at":"2024-01-11 19:41:45","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":16130,"visible":true,"origin":"","legend":"","description":"","filename":"ESM3.docx","url":"https://assets-eu.researchsquare.com/files/rs-2656092/v1/bc17046c70fba33525c6a1e7.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The association between common mental disorders, socioeconomic outcomes and social mobility: A systematic review","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe social selection and health selection theories have been proposed to explain how mental illness affects an individual\u0026rsquo;s social mobility [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These hypotheses state that individuals who experience mental illness are more likely to experience poverty, reduced economic productivity, and unemployment [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Social mobility is an individual\u0026rsquo;s upwards or downwards movement in social class and includes measures of income, education, and occupation. [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Amongst other factors, success in educational attainment, income and occupational status, have an important influence on an individual\u0026rsquo;s ability to function in society and experience upwards social mobility [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Individuals who experience upwards social mobility are more likely to maintain healthy relationships with their parents, spouse and friends; they are more likely to experience higher job satisfaction; and are more likely to find outside help in regards to attaining employment [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCommon mental health disorders (anxiety disorders, depressive disorders and post-traumatic stress disorders (CMDs)) have increased in prevalence despite the rise in the use of mental health services [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Given the increased prevalence of CMDs and the importance of experiencing upwards social mobility, it is imperative to understand the association between CMDs, socioeconomic outcomes, and subsequent social mobility. However, there are limited reviews investigating this association, this includes both the intergenerational association (parental mental health problems and their children\u0026rsquo;s socioeconomic outcomes and social mobility), and the intragenerational association (a person\u0026rsquo;s own mental health problems and changes to their socioeconomic outcomes and social mobility outcomes) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe aim of this systematic review is to synthesise current literature on the association between CMDs and changes to social mobility. Due to the lack of studies using strict measures of social mobility and social class, socioeconomic outcomes were used as proxies for social mobility including, education, occupation and income [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003eThis systematic review was conducted as part of a wider project (initiated by the Social Mobility Commission, UK) investigating the association between mental health problems and social mobility. A complementary paper, which explored the association between social class and the effectiveness of interventions for mental health disorders has recently been published [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The protocol for this review paper was not registered on PROSPERO as the review considered social rather than health outcomes. However, the protocol was written apriori and was followed without amendments. The protocol can be found in online resource 1. The review questions and conclusions were informed by advice from an expert reference group (Online resource 1).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Search strategy\u003c/h2\u003e \u003cp\u003eThe studies were identified using database and non-database search methods [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Seven bibliographic databases were searched including MEDLINE (1946-27/09/19), Embase (1980-27/09/19), PsycINFO (1806-09/19), Health Management Information Consortium (HMIC) (1979-05/19), Social Policy and Practice (SPP) (1890-27/09/2019), Applied Social Sciences Index and Abstracts (Assia) (01/01/1987\u0026ndash;27/09/2019), and Education Resources Information Center (ERIC) (1966-27/09/19). An updated search was conducted on March 17th 2021 and on May 20th 2022, to ensure all up-to-date studies were included in the review. The search strategies were assessed using the PRESS checklist [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The primary search strategy is reported using a search narrative to explain the contextual and conceptual detail behind the selection of search terms [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The following study design search filters were used: Canadian Agency for Drugs and Technologies in Health (CADATH), RCT/controlled clinical trial (CCT), and Scottish Intercollegiate Guidelines Network (SIGN) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The SIGN filter was adapted to target studies that report cohort or longitudinal designs. The searches were not limited by date or language.\u003c/p\u003e \u003cp\u003eNon-database (supplementary) searches were also conducted [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], including:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eChecking systematic reviews for included studies that met the inclusion criteria not identified in the bibliographic searches.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWeb-searching was conducted by one researcher using Google advanced interface, following Briscoe\u0026rsquo;s guidance [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIdentified studies that met inclusion criteria were shared with the expert reference group for them to identify any missing studies [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe studies were de-duplicated in EndNote X8 [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The full search strategy for the database and non-database search are reported in online resource 2.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Selection criteria\u003c/h2\u003e \u003cp\u003eStudies were included according to the following criteria:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCohort study design.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePopulation with a CMD.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eOutcomes reported that relate to social mobility and social class*.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003e(*Due to the limited data on measures of social mobility and social class, education, income, occupation and social class were included for study outcomes [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] ).\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eStudies were not excluded based on language. Studies on drug and alcohol- use disorders or neurodevelopmental disorders were excluded. Conference abstracts, dissertations, and study protocols were also excluded. The list of excluded studies and reasons for exclusion can be found in online resource 3.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study selection\u003c/h2\u003e \u003cp\u003eAll studies were initially screened independently by two reviewers at title and abstract, using Rayyan software [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. All studies that met inclusion at title and abstract were then double screened independently at full text. A third researcher was available where there were disagreements.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Quality appraisal\u003c/h2\u003e \u003cp\u003eThe Newcastle-Ottawa tool (modified by Gondek et al. 2018) was used to assess the quality of studies. Quality appraisal was initially conducted by one reviewer and then checked in detail by a second reviewer [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Studies that received a score of seven were reported as \u0026ldquo;good\u0026rdquo; quality, a score of six \u0026ldquo;fair\u0026rdquo; quality, and a score of five \u0026ldquo;poor\u0026rdquo; quality.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data Extraction\u003c/h2\u003e \u003cp\u003eData was extracted using an extraction tool developed and tested by the research team. The following data were extracted: study reference, study design, country and region of the study, setting, age, gender, ethnicity, mental health diagnosis and specific disorder studied, population characteristic, study purpose, exposure, comparison, social mobility outcome measured, method of measurement, limitations, and outcome data relevant to our research question.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Data synthesis\u003c/h2\u003e \u003cp\u003eThere was a high variability in study outcomes, populations, adjustments to statistics, and follow-up, therefore the data was synthesised narratively [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] by mental disorder and social mobility outcomes. Similar outcomes were grouped and differences between study outcomes were explained narratively.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Search results\u003c/h2\u003e \u003cp\u003eA total of 4792 studies were identified by the bibliographic and non-bibliographic searches after duplicates were removed. 4691 studies were excluded at title and abstract screening. 101 studies were screened at full text, with a total of 23 studies meeting the inclusion criteria. A further four studies were identified from update searches. Overall, a total of 27 studies met inclusion for the review. The systematic review process is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e (PRISMA diagram).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003ePRISMA Diagram\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy reference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCountry (region)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStudy design\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExposure\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eComparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDiagnostic criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean age\u003c/p\u003e \u003cp\u003e(range)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003cp\u003e(% female)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eFollow-up\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eStudy quality\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNorway\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12,287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health problems and a physical disability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health problems and a physical disability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNot reported (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.5 (not recorded [NR])\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e55.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e13 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmos et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39,479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTreatment-resistant depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR (18\u0026ndash;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e64.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAro et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMajor affective disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo major affective disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eICD-9 (Finnish version). which\u003c/p\u003e \u003cp\u003ehas adapted DSM-III-R criteria for mental disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e55.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e17 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBirtchnell [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003cp\u003e(Aberdeen)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4,159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eICD-7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eMultiple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eButterworth et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAustralia\u003c/p\u003e \u003cp\u003e(Melbourne)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13,969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxiety and depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo anxiety or depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e35.85 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e54.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCase et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17,409\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health and emotional problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health and emotional problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e42 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(Boston MA, Chicago IL, Iowa City IA, New York NY, St Louis MO)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eResearch diagnostic criteria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e39.15 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e67.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDenmark\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108,102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective Cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health problems (various)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health problems (various)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16\u0026ndash;24 (education)\u003c/p\u003e \u003cp\u003e25\u0026ndash;59 (employment)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eeducation: 5 years\u003c/p\u003e \u003cp\u003eemployment: 4 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(Baltimore MD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e907\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepression disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e43.2 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e55.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e16 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3,596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10.4 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e53.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e27 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnsminger et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(Chicago IL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePsychological distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo psychological distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eComposite International Diagnostic Interview (CIDI) (Michigan version) according to the criteria of DSM-III-R\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvans et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eParental postnatal mental health- Anxiety\u0026thinsp;+\u0026thinsp;Depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo parental mental health problems (less)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eEducational attainment at age 11, and rate of change in attainment age 7\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroffen et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNetherlands\u003c/p\u003e \u003cp\u003e(Eindhoven)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4,745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSocial anxiety disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo social anxiety disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e68.9 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHalonen et al. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinland\u003c/p\u003e \u003cp\u003e(Northern Finland)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9,432\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxiety and depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo anxiety or depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsohanni et al. [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinland\u003c/p\u003e \u003cp\u003e(Northern Finland)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11,017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNon-psychotic disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo non-psychotic disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDSM-III-R\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e49.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJohn et al. [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e437 412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental Disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCode lists adapted from ICD (version 10) for secondary care and read codes (version 2) 22 in primary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10.5 (7\u0026ndash;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1\u0026ndash;4 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJohnson et al. [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(New York NY)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective Cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxiety and depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo anxiety or depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDiagnostic Interview Schedule for Children (DISC-I)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e22.5 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e51.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhite: 91%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e19 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003cp\u003e(UK-wide)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8,496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxiety and depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo anxiety or depressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e53.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eBritish: 100%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e34 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLandstedt et al. [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSweden\u003c/p\u003e \u003cp\u003e(North Sweden)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e42 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e26 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeibner et al. [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eInternalising Mental Health Problems (MHP) (inwards-oriented symptoms of anxiety, depression, and social difficulties)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo internalizing MHP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eEmotional Symptoms Peer subscales adapted for internalised mental health problems score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e14.88 (11.01\u0026ndash;17.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e54.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.7% two-sided migration\u003c/p\u003e \u003cp\u003ebackground\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrause et al. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33.2 (NR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor quality (3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychogiou et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003cp\u003e(Avon)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13,988\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e16 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(New Haven CT)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDiagnostic interview schedule for affective disorders and schizophrenia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25 (18\u0026ndash;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e17 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGood quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSareen et al. [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34,653\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAlcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSellers et al. [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35,924\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChild mental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo child mental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRetrospective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDSM structured psychiatric interview\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e55.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEuropean American: 63%\u003c/p\u003e \u003cp\u003eAfrican American: 34%\u003c/p\u003e \u003cp\u003ePuerto Rican: 3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3\u0026ndash;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUS\u003c/p\u003e \u003cp\u003e(Michigan)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e753\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProspective cohort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSocial anxiety disorder or major depressive disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eBlack: 56%\u003c/p\u003e \u003cp\u003eWhite: 45%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFair quality (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.2 The association between CMDs and socioeconomic outcomes\u003c/h2\u003e \u003cp\u003eAll of the 27 studies investigated the intragenerational association between CMDs and changes in socioeconomic outcomes. Eight studies also investigated the intergenerational association between CMDs and changes in socioeconomic outcomes. One study [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] investigated the direct association between mental health and social mobility outcomes (change in social class from parent to child). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e provides a summary of findings.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe association between common mental health disorders, socioeconomic outcomes, and social mobility\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntragenerational/\u003c/p\u003e \u003cp\u003eintergenerational\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental health problem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStudy (quality)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFindings\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"17\" rowspan=\"18\"\u003e \u003cp\u003eEducational attainment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eIntergenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s educational attainment after controlling for parental SES (f ratio [F]\u0026thinsp;=\u0026thinsp;0, p\u0026nbsp;=\u0026nbsp;0.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnsminger et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMothers\u0026rsquo; distress during either their children\u0026rsquo;s childhood or adolescence did not significantly increase the odds of secondary school drop out in either sons (OR: 1.22, 95% CI: 0.72, 2.06, p\u0026thinsp;=\u0026thinsp;0.458) or daughters (OR: 0.94, 95% CI: 0.55, 1.63, p\u0026thinsp;=\u0026thinsp;0.823) when controlling for maternal educational attainment.\u003c/p\u003e \u003cp\u003eMothers\u0026rsquo; distress during their children\u0026rsquo;s childhood \u003cem\u003eand\u003c/em\u003e adolescence significantly increased the odds of secondary school drop out in sons (OR:\u0026nbsp;2.29, 95% CI: 1.20, 4.37, p\u0026thinsp;=\u0026thinsp;0.012) but not in daughters (OR: 1.12, 95% CI: 0.50, 2.49, p\u0026thinsp;=\u0026thinsp;0.782) when controlling for maternal educational attainment.\u003c/p\u003e \u003cp\u003eThere was a significant interaction between maternal distress and poverty: maternal distress at only one time point, when combined with poverty, did significantly increase the odds of school drop out in sons only (OR: 3.07, 95% CI: 1.02, 9.22, p\u0026thinsp;=\u0026thinsp;0.046).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive and Anxiety disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChildhood/Adolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEvans et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFrom ages 7\u0026ndash;16, parental mental health (composite score measured 1\u0026ndash;2 years after birth) was associated with a slightly slower rate of change in maths attainment (b=-0.004, 95% CI: -0.008, -0.00, p\u0026thinsp;=\u0026thinsp;0.036). An increase in mental health symptoms (by 1-unit) was associated with a decrease in maths attainment improvement per year by \u0026minus;\u0026thinsp;0.004 levels. At age 11, parental mental health did not predict maths attainment (b=-0.019, 95% CI: -0.037, 0.000, p\u0026thinsp;=\u0026thinsp;0.053).\u003c/p\u003e \u003cp\u003e(Controlled for: Parental education, IQ, Working memory, at home teaching, involvement and interaction of parent, sex).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorse mental health in mothers predicted reduced chances of their children gaining a degree by age 30 (b: -0.014, SE: 0.005, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eHowever, when controlling for child mental health at age 10, mental health of mothers did not predict reduced chances of the children gaining a degree by age 30 (b = -0.007, SE: 0.005, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Children\u0026rsquo;s mental health mediated the effect of their mothers\u0026rsquo; mental health and their own educational attainment.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePsychogiou et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMore severe depression in mothers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative mother-child relationships (b:-0.01. SE:0.002, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and prior educational attainment (b:-0.004, SE: 0.001, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). \u003c/p\u003e \u003cp\u003eMore severe depression in fathers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative father-child relationships (b: 0.008, SE: 0.003, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence/adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThere was no direct association between mothers\u0026rsquo; mental health and their children\u0026rsquo;s educational attainment in adulthood (b: 0.00, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eHowever, mothers\u0026rsquo; mental health was significantly associated with their children\u0026rsquo;s academic competence in adolescence (b: 0.20, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and mental health at age 18 (b: 0.22, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eThese child variables significantly predict educational attainment (academic competence b: 0.54, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, mental health b: 0.18, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"11\" rowspan=\"12\"\u003e \u003cp\u003eIntragenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIsohanni et al. [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] (Good quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople with non-psychotic disorders had increased odds of attaining basic (versus secondary or tertiary) education, whether with onset before age 22 (OR:3.2, 95% CI: 2.1, 4.7, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or at age 23 or older (OR: 3.1, 95% CI: 1.9\u0026ndash;5.3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e \u003cp\u003eFewer people with age of onset before 22 attained tertiary education (4%), while more with age of onset at 23 or older attained tertiary education (18%).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChildhood/Adolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohn et al. [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] (Good quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThere was an association between having a recorded mental health disorder and absenteeism (OR 2\u0026middot;9, 95% CI 2\u0026middot;8\u0026ndash;2\u0026middot;9), and of the 3.7% of pupils who had been excluded once, 20.8% were reported to have a mental disorder. Pupils with depression had slightly higher odds of being absent from school. However, there was no significant association between anxiety and absenteeism.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohnson et al. [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] (Good quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eControlling for comorbid mental health problems, parental SES, parental psychopathology, child\u0026rsquo;s age, child\u0026rsquo;s gender and child\u0026rsquo;s intelligence quotient, a diagnosis of an anxiety disorder was associated with a reduced risk of dropping out of secondary school (OR: 0.21, 95% CI: 0.05, 0.97, p\u0026thinsp;=\u0026thinsp;0.039). \u003c/p\u003e \u003cp\u003eA diagnosis of an anxiety disorder was not significantly associated with a failure to continue education beyond secondary school (OR: 1.59, 95% CI: 0.58, 4.42, p\u0026thinsp;=\u0026thinsp;0.371).\u003c/p\u003e \u003cp\u003eControlling for comorbid mental health problems, parental SES, parental psychopathology, child\u0026rsquo;s age, child\u0026rsquo;s gender and child\u0026rsquo;s intelligence quotient, a diagnosis of depression was associated with a reduced risk of dropping out of secondary school (OR: 0.23, 95% CI: 0.06, 0.82, p\u0026thinsp;=\u0026thinsp;0.028).\u003c/p\u003e \u003cp\u003eA diagnosis of depression was not significantly associated with a failure to continue education beyond secondary school (OR: 1.16, 95% CI: 0.43, 3.12, p\u0026thinsp;=\u0026thinsp;0.769).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSymptoms of Depressive and anxiety disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMeibner et al. [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] (Good quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThere was no significant association between individuals with \u0026lsquo;internalised\u0026rsquo; mental health problems (MHP), lower levels of educational attainment (r= -0.01, p\u0026thinsp;=\u0026thinsp;0.912), failure to achieve expected level of education (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.062), or drop out from vocational/academic training (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.054).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression was not a significant predictor of educational attainment (F\u0026thinsp;=\u0026thinsp;0.0, p\u0026thinsp;=\u0026thinsp;0.98) after controlling for parental SES.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult/adulthood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIndividuals 16\u0026ndash;24 years: Individuals with poor mental health were less likely to progress from basic education to short education (men: unadjusted HR: 0.72, 95% confidence interval (CI): 0.62\u0026ndash;0.85; women: unadjusted HR: 0.87, 95% CI: 0.79\u0026ndash;0.96).\u003c/p\u003e \u003cp\u003eShort education to medium/long education: Women (aged 16\u0026ndash;24 years) with poor mental health were less likely to progress from short education to medium/long education (unadjusted HR: 0.75; 95% CI: 0.62\u0026ndash;0.90). Men with poor mental health were not significantly less likely to progress from short education to medium/long education (HR: 0.84, 95% CI: 0.61\u0026ndash;1.17).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAdults with depression did not have significantly different odds of improving their educational attainment compared with controls (OR: 0.83, 95% 0.51, 1.35, p\u0026thinsp;=\u0026thinsp;0.46).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePoor childhood mental health significantly predicted reduced likelihood of getting a degree after controlling for maternal mental health, maternal education and parental social class (b: -0.023, SE: 0.005, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSellers et al. [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIn two different cohorts (ALSPAC and NCDS), children with mental health problems were less likely to go on to achieve a least five good exam passes than children without mental health problems (boys: NCDS: OR: 0.49, 95% CI: 0.31, 0.78, p\u0026thinsp;=\u0026thinsp;0.003, ALSPAC: OR: 0.30, 95% CI: 0.22, 0.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p\u0026thinsp;=\u0026thinsp;0.010, ALSPAC: OR: 0.34, 95% CI: 0.23, 0.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (no parental SES adjustment).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOffspring mental health at age 18 was significantly associated with educational attainment at age 30 (b: 0.018, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIn people with disability, controlling for gender and parental levels of education, poor mental health increased the chances of low levels of educational attainment (b: 0.136, SE: 0.019, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCase et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMental health or emotional problems at age 16 were associated with a reduced number of \u0026lsquo;O\u0026rsquo; level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16, mental problems at age 7 (b:-0.637, SE: 0.123, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eMental health or emotional problems at age 7 were also associated with a reduced number of \u0026lsquo;O\u0026rsquo; level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16 and mental impairments at age 16 (b: = -0.601, SE: 0.128, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003eIncome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIntergenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s income (F\u0026thinsp;=\u0026thinsp;0.03, p\u0026thinsp;=\u0026thinsp;0.87) after controlling for parental SES.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorse mental health in mothers predicted reduced household income for their children at age 30 (b:-0.036, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003eWhen controlling for child mental health at age 10, the association of mothers\u0026rsquo; mental health with reduced income for their children at age 30 became weaker but remained significant (b:-0.021, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Child and maternal mental health interacted to predict offspring income.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eParental depression did not predict personal income (b: -0.01, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) when controlling for fathers\u0026rsquo; job level or job percentile.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eIntragenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression was not a significant predictor of income after controlling for parental SES (F\u0026thinsp;=\u0026thinsp;0.95, p\u0026thinsp;=\u0026thinsp;0.33).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople with depression had significantly reduced odds of increasing their annual income over 5 years compared with controls (OR: 0.67, 95% CI: 0.46, 0.97, p\u0026thinsp;=\u0026thinsp;0.03).\u003c/p\u003e \u003cp\u003ePeople with depression did not have significantly different odds of decreasing their annual income over 5 years compared with controls (OR: 1.26, 95% CI: 0.69, 2.27, p\u0026thinsp;=\u0026thinsp;0.45).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIncome in adulthood was predicted by depressive symptoms.\u003c/p\u003e \u003cp\u003eLower initial levels and faster decrease over time in depressive symptoms were associated with higher income in adulthood (controlling for parental/childhood SES).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnxiety disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOlder adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGroffen et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOlder adults with a social anxiety disorder had increased odds of a decrease in income after adjusting for gender, age, educational attainment, baseline income and change in occupational status (OR: 1.69, 95% CI: 1.15, 2.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.008).\u003c/p\u003e \u003cp\u003eSocial anxiety disorder was related to a decrease in income regardless of educational attainment or income levels at baseline: these variables did not moderate the association (p\u0026thinsp;=\u0026thinsp;0.68).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eChildhood mental health does not predict adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.010 SE: 0.008, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eAdulthood mental health predicts adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.083, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSareen et al. [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThere were no significant relationships between baseline mental health problems and change in income status during the 3-year follow-up period (statistics not reported).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression had a small negative effect on income percentile at 10-year follow-up (b:\u0026minus;0.10, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"16\" rowspan=\"17\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIntergenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s occupation (F\u0026thinsp;=\u0026thinsp;1.13, p\u0026thinsp;=\u0026thinsp;0.29), after controlling for parental SES.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence/adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThere was no direct association between mothers\u0026rsquo; mental health and their children\u0026rsquo;s occupational status in adulthood (b: 0.08, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eHowever, mothers\u0026rsquo; mental health was significantly associated with their children\u0026rsquo;s mental health in adolescence (b: 0.22, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). This child variable significantly predicts occupational status (b: 0.19, 0\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eParents\u0026rsquo; depression did not predict their children\u0026rsquo;s occupation (b: 0.00, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) when controlling for fathers\u0026rsquo; job level or job percentile.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"13\" rowspan=\"14\"\u003e \u003cp\u003eIntragenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eButterworth et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] (Good quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMen with poor mental health were significantly more likely to become unemployed (b: 0.21, SE: 0.04, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and be unemployed for longer (b: 0.14, SE: 0.04 p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) compared with men with better mental health.\u003c/p\u003e \u003cp\u003eWomen with poor mental health are significantly more likely to become unemployed (b: 0.14, SE: 0.03, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), but were not more likely to be unemployed for longer (b: 0.04, SE: 0.03, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression was not a significant predictor of occupation after controlling for parental SES (F\u0026thinsp;=\u0026thinsp;1.07, p\u0026thinsp;=\u0026thinsp;0.30).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAmos et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople with treatment-resistant depression were 2.3 times more likely than employees without depressive disorders (HR: 2.29 95% CI: 1.44, 3.65, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) to switch to COBRA status (changed occupational status with reduced hours) during follow-up. \u003c/p\u003e \u003cp\u003eThere was significant difference between cohorts for employment termination (results not shown). \u003c/p\u003e \u003cp\u003ePeople with treatment-resistant depression were 1.4 times more likely than employees without depressive disorders (HR: 1.37, 95% CI: 1.11, 1.69, p\u0026thinsp;=\u0026thinsp;0.004) to either switch to COBRA status or terminate employment.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAro et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMen and women with major affective disorder had a 2.5\u0026ndash;3.9 times and 2.8\u0026ndash;4.2 times higher risk, respectively, of becoming unemployed than the general population.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYoung adult/adulthood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIndividuals in employment who experience poor mental health were more likely to become unemployed than those with good mental health (adjusted for education level and long-term illness, men aged 25\u0026ndash;44 HR:3.74, 95% CI: 2.65\u0026ndash;3.86, women aged 25\u0026ndash;44: 2.79, 95% CI: 2.48\u0026ndash;3.14, men aged 45\u0026ndash;59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45\u0026ndash;59 HR: 3.13, 95% CI: 2.72\u0026ndash;3.61).\u003c/p\u003e \u003cp\u003eIndividuals who are not employed with poor mental health were less likely to become employed (adjusted for education level, long term illness, smoking behaviour, alcohol consumption, BMI, physical activity, men aged 25\u0026ndash;44 HR: 0.56, 95% CI: 0.44\u0026ndash;0.72, women aged 25\u0026ndash;44 HR: 0.47, 95% CI: 0.39\u0026ndash;0.58, men aged 45\u0026ndash;59 HR: 0.50, 95% CI:0.38\u0026ndash;0.67, women aged 45\u0026ndash;59 HR: 0.43, 95% CI: 0.32, 0.59).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople with depression had significantly reduced odds of being employed in the previous year compared with controls (OR: 0.57, 95% CI: 0.39, 0.84, p\u0026thinsp;=\u0026thinsp;0.004).\u003c/p\u003e \u003cp\u003ePeople with depression had significantly reduced odds of improving their occupation over their lifetime best in the previous 5 years compared with controls (prevalence ratio [PR]: 0.45, 95% CI: 0.29, 0.69, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e \u003cp\u003ePeople with depression had significantly increased odds of decreasing their occupational status from their lifetime best in the previous 5 years compared with controls (OR: 1.89, 95% CI: 1.31, 2.73, p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOccupational status in adulthood was predicted by depressive symptoms. \u003c/p\u003e \u003cp\u003eLower initial levels and faster decrease over time in depressive symptoms were associated with higher occupational status in adulthood (controlling for parental/childhood SES).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdolescence/Adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHalonen et al. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSymptoms of mental health problems were not associated with increased odds of becoming employed at a different age, controlling for parental education and household income, compared with age\u0026thinsp;\u0026gt;\u0026thinsp;24: being age 19\u0026ndash;23: OR: 1.01 95% CI: 0.84, 1.23, p\u0026thinsp;=\u0026thinsp;0.919), being age\u0026thinsp;\u0026lt;\u0026thinsp;18: OR: 0.76 95% CI: 0.61, 0.95, p\u0026thinsp;=\u0026thinsp;0.015)\u003c/p\u003e \u003cp\u003eSymptoms of mental health problems were also not associated with a specific occupational class obtained during first employment. Low occupational class compared with intermediate: OR: 0.95 95% CI: 0.74, 1.22, p\u0026thinsp;=\u0026thinsp;0.688); non-specified compared with intermediate: OR: 0.93 95% CI: 0.73, 1.20, p\u0026thinsp;=\u0026thinsp;0.567).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOffspring mental health at age 18 significantly predicted occupational status at age 30 (b: 0.19, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] (Fair quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSymptoms of social anxiety disorder in the preceding month significantly predicted the number of months worked (b:-0.114 SE: 0.054, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eSymptoms of depressive disorder in the preceding month did not significantly predict the number of months worked (b:-0.012 SE: 0.031, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIn people with a physical disability, controlling for gender and parental education, poor mental health increased the chances of unemployment (b: 0.067, SE: 0.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression at baseline did not predict job percentile at 10-year follow-up (b\u0026thinsp;=\u0026thinsp;0.05, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05, data not shown)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLandstedt et al. [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] (poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepressive symptoms did not predict employment trajectories after controlling for occupational status.\u003c/p\u003e \u003cp\u003eMen: \u0026lsquo;medium\u0026rsquo;\u003csup\u003ec\u003c/sup\u003e education into stable employment: OR: 0.44 95% CI: 0.18, 1.10, p\u0026thinsp;=\u0026thinsp;0.075; \u0026lsquo;short\u0026rsquo; education into stable employment OR: 0.85 95% CI: 0.38, 1.90, p\u0026thinsp;=\u0026thinsp;0.692; continuously unstable situation: OR: 2.20 95% CI: 0.90, 5.46, p\u0026thinsp;=\u0026thinsp;0.086.\u003c/p\u003e \u003cp\u003eWomen: \u0026lsquo;short\u0026rsquo; education into stable employment OR: 1.69 95% CI: 0.66, 4.38, p\u0026thinsp;=\u0026thinsp;0.277; continuously unstable situation: OR: 1.92 95% CI: 0.64, 5.80, p\u0026thinsp;=\u0026thinsp;0.246.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepressive disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePrause et al. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] (poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMore severe depression was not associated with decreased odds of employment 2 years later in those who were unemployed at baseline (OR:\u0026nbsp;1.04, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), and in those who were underemployed at baseline (OR:\u0026nbsp;1.04, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The gap between employment rates of men and women did however decrease with increasing symptoms of depression.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial mobility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntragenerational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAny common mental health problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBirtchnell [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] (Poor quality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeople with depression showed significantly less upward social mobility (change in social class from parents) than people without depression in classes IV and V.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ea High\u0026minus;risk sample\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003eb Anxiety or depressive disorders\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ec \u0026rsquo;Medium\u0026rsquo; and \u0026lsquo;short\u0026rsquo; not defined by the study\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1 The association between CMDs and education\u003c/h2\u003e \u003cp\u003e \u003cb\u003eIntergenerational (Education)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSix studies investigated the association between parental mental health and the educational attainment of their child. One good quality study [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] reported that parental depression was not a significant predictor of a child\u0026rsquo;s education after controlling for parental socio-economic status (F\u0026thinsp;=\u0026thinsp;0, p\u0026thinsp;=\u0026thinsp;0.97). Three fair quality studies [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] reported no direct intergenerational association between mental health and educational outcomes in children. Findings showed that once the child\u0026rsquo;s mental health was taken into account, maternal mental health did not predict educational attainment in their children by age 30 (b=-0.007, Standard error (SE): 0.005, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. However another study reported some evidence to show that negative parent-child interactions of the mother (b:-0.01, SE: 0.002, p\u0026thinsp;\u0026lt;\u0026thinsp;.01) and father (b:0.008, SE:0.003, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) mediated the association between parental mental health and educational attainment [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Additionally, maternal health was associated with academic competence (b:-0.01, SE: 0.002, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], and the odds of high school dropout increased in sons when maternal depression was considered with poverty [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOnly one study of fair quality [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] reported that parental mental health significantly predicted a slightly slower rate of change in maths attainment between the ages of 7 to 16 (b=-0.004, 95% CI: -0.008, -0.00, p\u0026thinsp;=\u0026thinsp;0.036), with an increase in symptoms linked to a decreased growth in maths attainment per year.\u003c/p\u003e \u003cp\u003e \u003cb\u003eIntragenerational (Education)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTwelve studies investigated the association between an individual\u0026rsquo;s mental health and their educational attainment. Five studies of good quality evidence reported mixed findings. One study [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] reported that the risk of high school dropout was lower in those with anxiety and depression (OR: 0.21, 95% CI: 0.05, 0.97, p\u0026thinsp;=\u0026thinsp;0.039). Although a diagnosis of depression was not associated with failure to continue with education beyond high school (OR: 1.16, 95%, CI: 0.06, 0.82, p\u0026thinsp;=\u0026thinsp;0.028) [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Another study [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] reported that mental health disorders were associated with absenteeism (OR: 2.9, 95% CI: 2.8\u0026ndash;2.9). Considering this association by sex, boys with depression were more likely to be absent from school compared with girls (OR: 0.8, CI: 0.8, 0.9, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001); this was not the case with anxiety disorders (OR: 1.0, CI: 0.9, 1.0, p\u0026thinsp;=\u0026thinsp;0.072) [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Boys with anxiety (OR: 2.0, CI: 1.8, 2.2, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or depressive disorders (OR: 1.9 CI: 1.7, 2.1, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) were more likely to be excluded compared with girls [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Considering academic achievements, one study [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] reported that patients with nonpsychotic disorders before the age of 22 had increased odds (triple) of achieving just basic education, compared with secondary or tertiary education (OR:3.2, 95%, CI:2.1, 4.7, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), and compared with individuals experiencing onset age 23 or older (OR:3.1, 95% CI: 1.9\u0026ndash;5.3, p\u0026thinsp;\u0026lt;\u0026thinsp;.00001).\u003c/p\u003e \u003cp\u003eContrary to the evidence identified so far, two studies of good quality, did not find an association. One study reported that depression was not a significant predictor of educational attainment (F\u0026thinsp;=\u0026thinsp;0.0, p\u0026thinsp;=\u0026thinsp;0.98) [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] and another [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] found no significant association between individuals with \u0026lsquo;internalised\u0026rsquo; mental health problems (MHP), lower levels of educational attainment (r= -0.01, p\u0026thinsp;=\u0026thinsp;0.912), failure to achieve expected level of education (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.062), or drop out from vocational/academic training (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.054) [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. However, further analyses showed that there was an association by age on \u0026lsquo;internalised\u0026rsquo; MHP and attaining lower levels of education (b\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.13, Wald X\u0026sup2;(1,N\u0026thinsp;=\u0026thinsp;433)\u0026thinsp;=\u0026thinsp;4.19, p\u0026thinsp;=\u0026thinsp;0.041) [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThree fair quality studies reported an association between poor mental health and educational attainment. Individuals with poor mental health were less likely to progress from basic education (primary school), to short-term education (upper secondary/vocational school) (men: unadjusted Hazard Ratio (HR): 0.72, 95% confidence interval (CI): 0.62\u0026ndash;0.85; women: unadjusted HR: 0.87, 95% CI: 0.79\u0026ndash;0.96) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Furthermore, women with poor mental health were less likely to progress from short-term to medium/long-term education (unadjusted HR: 0.75; 95% CI: 0.62\u0026ndash;0.90) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Poor childhood mental health reduced the likelihood of getting a degree (b:-0.023, SE: 0.005, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], and mental health issues at 18 were significantly associated with educational attainment by age 30 (b: 0.018, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Additionally, children with poor mental health were less likely to achieve five good exam passes compared with children without (Boys: National Child Development Study (NCDS): Odds ratio (OR): 0.49, 95% CI: 0.31, 0.78, p\u0026thinsp;=\u0026thinsp;0.003 Avon Longitudinal Study of Parents and Children (ALSPAC) OR: 0.30, 95% CI: 0.22, 0.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, Girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p\u0026thinsp;=\u0026thinsp;0.010, ALSPAC: OR:b\u0026thinsp;+\u0026thinsp;0.34, 95% CI: 0.23, 0.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. However, one study of fair quality [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] did not find an association between adults with depression and in those without, on improving their educational status over a 5-year period (OR: 0.83, 95% 0.51, 1.35, p\u0026thinsp;=\u0026thinsp;0.46) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTwo studies of poor quality [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] reported on the association between childhood mental health and achievements in secondary level education. Those aged 7 and 16 with mental health problems were more likely to achieve a reduced level of O-level passes (b:-0.637, SE:0.123, p\u0026thinsp;\u0026gt;\u0026thinsp;.05) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Finally, young people with depression and/or an anxiety disorder and a physical disability were more likely to achieve low levels of secondary education (b:0.136, SE:0.019, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) (b:0.136, SE:0.019, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eSummary (Education)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe evidence suggests that parental mental health is not directly associated with their child\u0026rsquo;s education. However, when mediating factors are considered, such as parent-child interactions, parental mental health is associated with their child\u0026rsquo;s educational outcomes and progression.\u003c/p\u003e \u003cp\u003eThe evidence for the association between a person\u0026rsquo;s own mental health and educational outcomes varied, but there was some evidence that experiencing poor mental health at a younger age was more likely to be associated with poorer educational outcomes. The findings provide some insight into CMDs and how individuals progress through education.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2 The association between CMDs and income\u003c/h2\u003e \u003cp\u003e \u003cb\u003eIntergenerational (Income)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThree studies (one good quality [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], one fair quality [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] and one poor quality [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]) investigated the intergenerational association of CMDs on income. Two of the studies reported that parental CMDs (depressive disorders) were not a predictor of their children\u0026rsquo;s income (F\u0026thinsp;=\u0026thinsp;0.03, p\u0026thinsp;=\u0026thinsp;0.87) [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], (b: -0.01, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. However, one fair quality study [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] reported that maternal CMDs (anxiety and depression) predicted a reduced household income for children at age 30 (b: -0.036, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cb\u003eIntragenerational (Income)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSeven studies considered the intragenerational association of CMDs on income. One good quality study [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] reported that depression was not a significant predictor of income (F\u0026thinsp;=\u0026thinsp;0.95, p\u0026thinsp;=\u0026thinsp;0.33). Five fair quality studies reported mixed results. One study [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] reported that social anxiety increased the odds of a decreased income in adults (O: 1.69, 95% CI:1.15, 2.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.008). Considering depressive disorders, one study [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] reported that patients with depression had reduced odds of increasing their annual income (OR: 0.67, 95% CI: 0.46, 0.97, p\u0026thinsp;=\u0026thinsp;0.03), but did not significantly differ in odds of decreasing their annual income over a 5-year period (OR: 1.26, 95% CI: 0.69, 2.27, p\u0026thinsp;=\u0026thinsp;0.45). Another study [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] reported that childhood mental health problems (anxiety and depression) did not predict adult income (b:-0.010 SE: 0.008, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), though adult mental health predicted adult income (b:-0.083, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Furthermore, one study reported that depressive symptoms predicted adulthood income, with lower initial levels of depression and a faster decrease in symptoms associated with higher income in adulthood [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. One study reported on young adults and found that over a 3-year period, there was no significant association between baseline mental health problems and income [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. A study of poor quality study [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] reported that at 10-year follow-up, there was a small negative association between depression in adulthood and income percentile (b:-0.10, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cb\u003eSummary (Income)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe evidence shows that parental mental health problems/CMDs may have a limited association on their child\u0026rsquo;s income. The evidence for the association between one\u0026rsquo;s own mental health and income outcomes were varied. However, a key finding of the evidence that reported an association is that income was more likely to be affected in individuals who have experienced a CMD in later adulthood.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003e3.2.3 The association between CMDs and occupation\u003c/h2\u003e \u003cp\u003e \u003cb\u003eIntergenerational (Occupation)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThree studies (one of good quality [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], and two of fair quality [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]) investigated the association between parental CMDs and their child\u0026rsquo;s occupation. Parental depression was not associated with their children\u0026rsquo;s occupation (F\u0026thinsp;=\u0026thinsp;1.13, p\u0026thinsp;=\u0026thinsp;0.29) [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], even after controlling for the father\u0026rsquo;s job level (b:0.00, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. One study reported that there was no association between the mental health of mothers and their children\u0026rsquo;s occupational status (b:0.08, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. However, maternal mental health was associated with adolescent mental health (b:0.22, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), which predicted occupational attainment (b:0.19, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eIntragenerational (Occupation)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFourteen studies investigated the intragenerational association between mental health and occupation. One study of good quality [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] reported that men with depressive and anxiety disorders were more likely to become unemployed and be unemployed for longer compared with men with better mental health. Women were also more likely to become unemployed but were not more likely to be unemployed for longer [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. However, another good quality study [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] did not find any association in young adults (F\u0026thinsp;=\u0026thinsp;1.07, p\u0026thinsp;=\u0026thinsp;0.30).\u003c/p\u003e \u003cp\u003eThree studies of fair quality reported a significant association between mental health conditions and occupational status. Adulthood occupational status was predicted by depressive symptoms, as lower initial levels and faster decrease in symptoms over time were associated with higher occupational status [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Also, occupational status at age 30 was predicted by mental health at age 18 (b: 0.19, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Considering this association further, patients with depression, (compared with controls) had reduced odds of being employed in the previous year of the study (OR: 0.57, 95% CI: 0.39, 0.84, p\u0026thinsp;=\u0026thinsp;0.004), had reduced odds of improving their occupation over their lifetime best in the last 5 years (OR: 0.45, 95% CI:0.29, 0.69, p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), and had increased odds of decreasing their occupational status from their lifetime best over a 5-year period (OR: 1.89, 95% CI:1.31, 2.72, p\u0026thinsp;=\u0026thinsp;.001) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFive fair quality studies reported on the association of mental health problems and employment. Social anxiety predicted the number of months worked (b:-0.114 SE: 0.054, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), though symptoms of depression did not significantly do so (b:-0.012 SE: 0.031, p\u0026thinsp;\u0026gt;\u0026thinsp;.05) [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Another study [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] reported that symptoms of depression and anxiety increased the odds of being employed before 18 years (those above 24 years compared with 19\u0026ndash;23 years: OR: 1.01, 95% CI: 0.84, 1.23, p\u0026thinsp;=\u0026thinsp;0.919, versus those below 18 years: OR: 0.76, 95% CI: 0.61, 0.95, p\u0026thinsp;=\u0026thinsp;0.015). One study reported [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] that men and women with major affective disorder had a higher risk (men: 2.5\u0026ndash;3.9 times and women: 2.8\u0026ndash;4.2 times higher risk) of becoming unemployed than the general population. Another study [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] reported that employees with treatment-resistant depression (TRD) were more likely to switch to working fewer hours during follow up (Consolidated Omnibus Budget Reconciliation [COBRA] status) (HR: 2.29 95% CI:1.44, 3.65, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), or stopped employment (HR: 1.37, 95% CI:1.11, 1.69, p\u0026thinsp;=\u0026thinsp;0.004), than employees without depression. Finally, one [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] study reported that Individuals with poor mental health were more likely to become unemployed (men aged 25\u0026ndash;44: HR:3.74, 95% CI: 2.65\u0026ndash;3.86, women aged 25\u0026ndash;44: 2.79, 95% CI: 2.48\u0026ndash;3.14, men aged 45\u0026ndash;59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45\u0026ndash;59 HR: 3.13, 95% CI: 2.72\u0026ndash;3.61). More specifically, individuals with poor mental health were less likely to take on employment compared with unemployed individuals with good mental health (men aged 25\u0026ndash;44 HR: 0.56, 95% CI: 0.44\u0026ndash;0.72, women aged 25\u0026ndash;44 HR: 0.47, 95% CI: 0.39\u0026ndash;0.58, men aged 45\u0026ndash;59 HR: 0.50, 95% CI:0.38\u0026ndash;0.67, women aged 45\u0026ndash;59 HR: 0.43, 95% CI: 0.32, 0.59).\u003c/p\u003e \u003cp\u003eThree poor quality studies did not find a significant association between mental health problems and changes in occupational status. An individual\u0026rsquo;s employment trajectory and depressive symptoms were not associated [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e], and depressive symptoms at baseline did not predict job percentile (b: 0.067, SE: 0.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Furthermore, severity of depression was not associated with a decreased odds of employment 2 years later in those who were unemployed at baseline (Or: 1.04, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. However, an additional poor quality study did report that in patients with a physical disability, symptoms of anxiety and depression increased chances of unemployment (b: 0.067, SE: 0.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eSummary (occupation)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMost studies did not investigate the intergenerational association, however the few studies that did find some evidence, suggested that parental CMDs are associated with their child\u0026rsquo;s CMD and subsequently their occupational status. Findings for the effect of a person\u0026rsquo;s CMD on employment outcomes were mixed, although a number of fair quality studies reported an association between an individual\u0026rsquo;s mental health, occupational status, and employment status. In view of all the (limited) evidence, CMDs may be associated with unemployment status.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003e3.2.4 The association between CMDs and social mobility\u003c/h2\u003e \u003cp\u003e \u003cb\u003eIntergenerational (social mobility)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOne study (poor quality) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] examined the direct measure of social mobility by assessing the change in social class of patients with mental health disorders to that of their parents. Patients with depression showed less upward social mobility (change in social class from parents) than people without depression in classes IV (partly skilled occupations[\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]) and V (unskilled occupations [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eOverall, there is more evidence to suggest that there is a negative association between a person\u0026rsquo;s own experience (intragenerational) of a CMD, and their ability to improve their socioeconomic outcomes and social mobility within their own lifetime [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], compared with the intergenerational effects of CMDs [\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan additionalcitationids=\"CR31\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Evidence from this review reinforces the significance of both the social selection and the health selection theory [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The evidence also highlights the necessity of policies that support the implementation of interventions that adequately equip individuals to maintain their own mental health, with the wider goal of improving their socioeconomic outcomes and therefore their upwards social mobility.\u003c/p\u003e \u003cp\u003eDespite the association between CMDs, socioeconomic outcomes and social mobility, there were some studies that showed no association at all [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. This variation in findings may have occurred due to the different measures used to identify those with a CMD. Although a number of studies used official diagnostic tools to measure symptoms of CMDs, participants presented with symptoms varying in severity. As a result, whilst all participants would have experienced some symptoms, only some participants presented with symptoms severe enough to receive a formal diagnosis. Therefore, the association between clinically diagnosed CMDs and socioeconomic outcomes may be underestimated.\u003c/p\u003e \u003cp\u003eThere was some association between occupation and income level with the duration of illness (depression), severity of illness, and treatment resistant depression [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. It is important to understand how this affects individuals with chronic mental illness who may attain employment but experience poor work progression [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], considering that maintaining employment is often regarded as a key outcome of treatment of people experiencing a mental health disorder [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. Individuals who experience lower symptom severity and faster recovery earlier on in illness are not as affected, achieving a higher occupational status [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. This reinforces the importance of early intervention services to quickly identify and treat CMD symptoms before they have a more detrimental impact. This will enable individuals to have an equal opportunity to experience upwards social mobility, and improve employment prospects, despite the initial negative impact a CMD may have.\u003c/p\u003e \u003cp\u003eStudies reported a negative association between an individual\u0026rsquo;s own mental health and educational outcomes [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], but there was a weak association between parental mental health and their child\u0026rsquo;s educational outcomes [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. However, there are mediating factors that explain how parental mental health problems may be associated with a child\u0026rsquo;s mental health and therefore their educational attainment. One factor included parent-child interactions [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Research has shown that interventions that target how mothers with CMDs perceive and interact with their children, results in mothers having a positive view of their children [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. This leads to improved parent-child interactions and better social mobility outcomes for the child [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. Therefore, a healthy parent-child relationship may be a protective factor, which can counteract the negative association between one\u0026rsquo;s own mental health and subsequent educational outcomes.\u003c/p\u003e \u003cp\u003eA range of studies highlighted the negative impact that experiencing a CMD at a younger age has on education [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Early age onset of CMDs are associated with chronic mental illness [\u003cspan additionalcitationids=\"CR58\" citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], but despite this association, the effects and prevalence rates of CMDs are under investigated in adolescent groups globally [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Furthermore, the number of young people accessing child and adolescent mental health services is significantly lower than the overall prevalence rate [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. There is a clear need for further research into the burden of adolescent mental disorders, and for alternative mental health interventions that extend into environments that affect the lives of young people, such as the education system at secondary and university level, to be established.\u003c/p\u003e \u003cp\u003eGenerally research has shown positive effects of various interventions on academic achievement and school grades [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. One study evaluated the effects of a school-based intervention on student\u0026rsquo;s mental health [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]. Results showed that a decrease in symptoms of anxiety and depression were associated with an increase in self-esteem. High self-esteem has been linked with increased academic performance [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. Based on this evidence, and with the increased pressure on community health teams, future research investigating school-based interventions and implementing policies to mitigate the negative impact of CMDs highlighted in this review, are of high importance.\u003c/p\u003e \u003cp\u003eAlthough few studies focused on the impact of anxiety on income, education and occupation, two studies did report a negative association. Both studies found that social anxiety increased the likelihood of an individual experiencing a decrease in income, and working fewer hours [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Symptoms of social anxiety include embarrassment or fear of social situations [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. These symptoms can have a detrimental impact on an individual\u0026rsquo;s ability to function in the work environment where they may experience fear of speaking in front small groups, leading to fewer opportunities at work [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e] [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. Providing adjustments within the work environment for individuals with social anxiety could increase efficiencies and reduce the financial burden to the individual and society as a result of social anxiety.\u003c/p\u003e"},{"header":"5. Limitations","content":"\u003cp\u003eThere are a number of limitations to note. Although socioeconomic factors have been widely investigated, only one study reported on direct measures of social mobility. More high quality research using clearly defined social mobility measures, such as change in social class, should be conducted. This will enable policies to be developed around mental health interventions most needed in society, combat long-term unemployment, and improve employment prospects and income for people with CMDs [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe literature in this review included notably fewer studies on anxiety disorders. Anxiety disorders are amongst the most common mental disorders [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e], and can cause particularly adverse consequences in women, young adults and individuals from some minoritised ethnic groups [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. Although the studies included in the current review had good representation for both men, women and young adults, individuals from minoritised ethnic groups were seldom included. This is particularly important as some individuals from minoritised ethnic groups are more likely to experience unique life stressors, anxiety around discrimination and racism [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e] and misconceptions about immigration [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. This may potentially hinder upwards social mobility in ways not observed in other ethnic groups that have been widely investigated.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eIn conclusion, there is more evidence to suggest a negative intragenerational (than intergenerational) association between CMDs, reduced educational attainment, occupational status, and income. This highlights the need to further adapt mental health interventions into work and school environments, to equip individuals to take care of their own mental health, where community based health team may be limited. However, it is still important to understand how relationships in families, where parents are experiencing symptoms of mental health disorders may impact children, and provide additional support to mitigate the potential impact on social mobility. Future research investigations should focus on investigating CMDs and direct measures of social mobility such as social class. Furthermore, investigations should increase the participation of individuals who experience anxiety disorders and individuals from minoritised ethnic backgrounds, to better understand the unique ways CMDs impact changes to their socioeconomic outcomes and subsequent social mobility.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis review was conducted as part of a wider project supported by the Social Mobility Commission (GOV UK). No sponsors were involved in the review methods, data collection, analysis, in the writing of the report, or submission of the article for publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eFox, J.W. (1990) Social class, mental illness, and social mobility: the social selection-drift hypothesis for serious mental illness. 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Journal of Happiness Studies. 15(6): p.\u0026nbsp;1289\u0026ndash;1311.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBooth, M.Z. and J.M. Gerard (2011) Self-esteem and academic achievement: a comparative study of adolescent students in England and the United States. Compare: A Journal of Comparative and International Education. 41(5): p.\u0026nbsp;629\u0026ndash;648.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNICE (2013) Social anxiety disorder: recognition, assessment and treatment. London: National Collaborating Centre for Mental Health. British Psychological Society.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAcarturk, C., et al. (2009) Economic costs of social phobia: a population-based study. Journal of Affective Disorders. 115(3): p.\u0026nbsp;421\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStuhldreher, N., et al. (2014) The costs of social anxiety disorder: the role of symptom severity and comorbidities. Journal of Affective Disorders. 165: p.\u0026nbsp;87\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarr, B., P. Kinderman, and M (2015) Whitehead, Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013. Social Science \u0026amp; Medicine. 147: p.\u0026nbsp;324\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNunn, A., et al. (2007) Factors influencing social mobility.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRemes, O., et al. (2016) A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and Behavior. 6(7): p.\u0026nbsp;e00497.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWallace, S., J. Nazroo, and L. Becares (2016) Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. American journal of public health. 106(7): p.\u0026nbsp;1294\u0026ndash;300.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eValentin-Cortes, M., et al. (2020) Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants. American Journal of Community Psychology. 66(3\u0026ndash;4): p.\u0026nbsp;325\u0026ndash;336.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Unsectioned Paragraphs","content":"\u003cp\u003e\u003cem\u003eORCID ID: 0000-0002-1206-1519\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eWord count: 4436\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eDeclarations of interest\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eNone.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;1 Characteristics of included studies\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;2: The association between common mental health disorders, socioeconomic outcomes, and social mobility\u003c/p\u003e\u003cp\u003e\u003csup\u003ea High\u0026minus;risk sample\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003eb Anxiety or depressive disorders\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003ec \u0026rsquo;Medium\u0026rsquo; and \u0026lsquo;short\u0026rsquo; not defined by the study\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eFig.\u0026nbsp;1\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003ePRISMA Diagram\u003c/p\u003e\u003cp\u003e\u003csup\u003e \u003cb\u003eFig. 1\u003c/b\u003e PRISMA Diagram. Studies that were included were conducted in various countries (Norway K = 1, USA K = 10, Finland K = 4, UK K = 6, Australia K = 1, Denmark K = 1, Netherlands K = 1, Wales K = 1, Sweden K = 1, Germany K = 1). The quality of the evidence identified also varied, 6 studies rated as good quality, 15 studies rated as fair quality, and 6 studies rated as poor quality. Table 1 provides a characteristics summary of each included study\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003ea High\u0026minus;risk sample\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003eb Anxiety or depressive disorders\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003ec \u0026rsquo;Medium\u0026rsquo; and \u0026lsquo;short\u0026rsquo; not defined by the study\u003c/sup\u003e\u003c/p\u003e"},{"header":"Unsectioned Tables","content":" \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eStudy reference\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eCountry (region)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eSample size\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eStudy design\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eExposure\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eComparison\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiagnostic criteria\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eMean age\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(range)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eGender\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(% female)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eEthnicity\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eFollow-up\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eStudy quality\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNorway\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e12,287\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health problems and a physical disability\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health problems and a physical disability\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNot reported (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e28.5 (not recorded [NR])\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e55.1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e13 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAmos et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e39,479\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eTreatment-resistant depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR (18\u0026ndash;64)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e64.2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAro et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFinland\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e6,521\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMajor affective disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo major affective disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eICD-9 (Finnish version). which\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ehas adapted DSM-III-R criteria for mental disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e55.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e17 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBirtchnell [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Aberdeen)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4,159\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eICD-7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eMultiple\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eButterworth et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAustralia\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Melbourne)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e13,969\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnxiety and depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo anxiety or depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e35.85 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e54.1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e5 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (7)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCase et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e17,409\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health and emotional problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health and emotional problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e42 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Boston MA, Chicago IL, Iowa City IA, New York NY, St Louis MO)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e480\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eResearch diagnostic criteria\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e39.15 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e67.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDenmark\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e108,102\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective Cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health problems (various)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health problems (various)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e16\u0026ndash;24 (education)\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e25\u0026ndash;59 (employment)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e46\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eeducation: 5 years\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eemployment: 4 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Baltimore MD)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e907\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e43.2 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e55.1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e16 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (3)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFinland\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e3,596\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.4 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e53.8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e27 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEnsminger et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Chicago IL)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1,242\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003ePsychological distress\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo psychological distress\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eComposite International Diagnostic Interview (CIDI) (Michigan version) according to the criteria of DSM-III-R\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEvans et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e7465\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eParental postnatal mental health- Anxiety\u0026thinsp;+\u0026thinsp;Depression\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo parental mental health problems (less)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eEducational attainment at age 11, and rate of change in attainment age 7\u0026ndash;16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGroffen et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNetherlands\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Eindhoven)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4,745\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSocial anxiety disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo social anxiety disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e68.9 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e47.8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e3 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHalonen et al. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFinland\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Northern Finland)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e9,432\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnxiety and depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo anxiety or depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e50.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e30 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eIsohanni et al. [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFinland\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Northern Finland)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e11,017\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eNon-psychotic disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo non-psychotic disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eDSM-III-R\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e49.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (7)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohn et al. [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eWales\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e437 412\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental Disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eCode lists adapted from ICD (version 10) for secondary care and read codes (version 2) 22 in primary care\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.5 (7\u0026ndash;16)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e48.9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u0026ndash;4 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (7)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnson et al. [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(New York NY)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e736\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective Cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnxiety and depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo anxiety or depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiagnostic Interview Schedule for Children (DISC-I)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.5 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e51.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eWhite: 91%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e19 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(UK-wide)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e8,496\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnxiety and depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo anxiety or depressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e53.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eBritish: 100%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e34 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eLandstedt et al. [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eSweden\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(North Sweden)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1,083\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e42 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e48.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e26 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMeibner et al. [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGermany\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e433\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eInternalising Mental Health Problems (MHP) (inwards-oriented symptoms of anxiety, depression, and social difficulties)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo internalizing MHP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eEmotional Symptoms Peer subscales adapted for internalised mental health problems score\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e14.88 (11.01\u0026ndash;17.98)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e54.7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e6.7% two-sided migration\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ebackground\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e6 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (6)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePrause et al. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1,160\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e33.2 (NR)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e2 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor quality (3)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePsychogiou et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Avon)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e13,988\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e48.6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e16 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(New Haven CT)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e756\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiagnostic interview schedule for affective disorders and schizophrenia\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e25 (18\u0026ndash;49)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e17 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eGood quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSareen et al. [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e34,653\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eAlcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e3 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSellers et al. [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUK\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e35,924\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eChild mental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo child mental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e48.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e196\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eRetrospective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health problems\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eDSM structured psychiatric interview\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e55.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eEuropean American: 63%\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eAfrican American: 34%\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ePuerto Rican: 3%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u0026ndash;30 years\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (5)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUS\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Michigan)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e753\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProspective cohort\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSocial anxiety disorder or major depressive disorder\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eNR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e100.0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eBlack: 56%\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eWhite: 45%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e1 year\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eFair quality (4)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eOutcome\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntragenerational/\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eintergenerational\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health problem\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eStudy (quality)\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eFindings\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"17\" rowspan=\"18\"\u003e \u003cdiv class=\"SimplePara\"\u003eEducational attainment\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"5\" rowspan=\"6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntergenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s educational attainment after controlling for parental SES (f ratio [F]\u0026thinsp;=\u0026thinsp;0, p\u0026nbsp;=\u0026nbsp;0.97)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003csup\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eb\u003c/span\u003e\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eEnsminger et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMothers\u0026rsquo; distress during either their children\u0026rsquo;s childhood or adolescence did not significantly increase the odds of secondary school drop out in either sons (OR: 1.22, 95% CI: 0.72, 2.06, p\u0026thinsp;=\u0026thinsp;0.458) or daughters (OR: 0.94, 95% CI: 0.55, 1.63, p\u0026thinsp;=\u0026thinsp;0.823) when controlling for maternal educational attainment.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eMothers\u0026rsquo; distress during their children\u0026rsquo;s childhood \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eand\u003c/span\u003e adolescence significantly increased the odds of secondary school drop out in sons (OR:\u0026nbsp;2.29, 95% CI: 1.20, 4.37, p\u0026thinsp;=\u0026thinsp;0.012) but not in daughters (OR: 1.12, 95% CI: 0.50, 2.49, p\u0026thinsp;=\u0026thinsp;0.782) when controlling for maternal educational attainment.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eThere was a significant interaction between maternal distress and poverty: maternal distress at only one time point, when combined with poverty, did significantly increase the odds of school drop out in sons only (OR: 3.07, 95% CI: 1.02, 9.22, p\u0026thinsp;=\u0026thinsp;0.046).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive and Anxiety disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eChildhood/Adolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eEvans et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eFrom ages 7\u0026ndash;16, parental mental health (composite score measured 1\u0026ndash;2 years after birth) was associated with a slightly slower rate of change in maths attainment (b=-0.004, 95% CI: -0.008, -0.00, p\u0026thinsp;=\u0026thinsp;0.036). An increase in mental health symptoms (by 1-unit) was associated with a decrease in maths attainment improvement per year by \u0026minus;\u0026thinsp;0.004 levels. At age 11, parental mental health did not predict maths attainment (b=-0.019, 95% CI: -0.037, 0.000, p\u0026thinsp;=\u0026thinsp;0.053).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(Controlled for: Parental education, IQ, Working memory, at home teaching, involvement and interaction of parent, sex).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eWorse mental health in mothers predicted reduced chances of their children gaining a degree by age 30 (b: -0.014, SE: 0.005, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eHowever, when controlling for child mental health at age 10, mental health of mothers did not predict reduced chances of the children gaining a degree by age 30 (b = -0.007, SE: 0.005, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Children\u0026rsquo;s mental health mediated the effect of their mothers\u0026rsquo; mental health and their own educational attainment.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003ePsychogiou et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMore severe depression in mothers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative mother-child relationships (b:-0.01. SE:0.002, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and prior educational attainment (b:-0.004, SE: 0.001, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eMore severe depression in fathers was significantly associated with lower academic attainment in their children at age 16, through indirect associations via negative father-child relationships (b: 0.008, SE: 0.003, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence/adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eThere was no direct association between mothers\u0026rsquo; mental health and their children\u0026rsquo;s educational attainment in adulthood (b: 0.00, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eHowever, mothers\u0026rsquo; mental health was significantly associated with their children\u0026rsquo;s academic competence in adolescence (b: 0.20, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and mental health at age 18 (b: 0.22, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eThese child variables significantly predict educational attainment (academic competence b: 0.54, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, mental health b: 0.18, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"11\" rowspan=\"12\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntragenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eIsohanni et al. [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] (Good quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with non-psychotic disorders had increased odds of attaining basic (versus secondary or tertiary) education, whether with onset before age 22 (OR:3.2, 95% CI: 2.1, 4.7, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or at age 23 or older (OR: 3.1, 95% CI: 1.9\u0026ndash;5.3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eFewer people with age of onset before 22 attained tertiary education (4%), while more with age of onset at 23 or older attained tertiary education (18%).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eChildhood/Adolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohn et al. [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] (Good quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eThere was an association between having a recorded mental health disorder and absenteeism (OR 2\u0026middot;9, 95% CI 2\u0026middot;8\u0026ndash;2\u0026middot;9), and of the 3.7% of pupils who had been excluded once, 20.8% were reported to have a mental disorder. Pupils with depression had slightly higher odds of being absent from school. However, there was no significant association between anxiety and absenteeism.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnson et al. [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] (Good quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eControlling for comorbid mental health problems, parental SES, parental psychopathology, child\u0026rsquo;s age, child\u0026rsquo;s gender and child\u0026rsquo;s intelligence quotient, a diagnosis of an anxiety disorder was associated with a reduced risk of dropping out of secondary school (OR: 0.21, 95% CI: 0.05, 0.97, p\u0026thinsp;=\u0026thinsp;0.039). \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eA diagnosis of an anxiety disorder was not significantly associated with a failure to continue education beyond secondary school (OR: 1.59, 95% CI: 0.58, 4.42, p\u0026thinsp;=\u0026thinsp;0.371).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eControlling for comorbid mental health problems, parental SES, parental psychopathology, child\u0026rsquo;s age, child\u0026rsquo;s gender and child\u0026rsquo;s intelligence quotient, a diagnosis of depression was associated with a reduced risk of dropping out of secondary school (OR: 0.23, 95% CI: 0.06, 0.82, p\u0026thinsp;=\u0026thinsp;0.028).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eA diagnosis of depression was not significantly associated with a failure to continue education beyond secondary school (OR: 1.16, 95% CI: 0.43, 3.12, p\u0026thinsp;=\u0026thinsp;0.769).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eSymptoms of Depressive and anxiety disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eMeibner et al. [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] (Good quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eThere was no significant association between individuals with \u0026lsquo;internalised\u0026rsquo; mental health problems (MHP), lower levels of educational attainment (r= -0.01, p\u0026thinsp;=\u0026thinsp;0.912), failure to achieve expected level of education (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.062), or drop out from vocational/academic training (r\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;=\u0026thinsp;0.054).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression was not a significant predictor of educational attainment (F\u0026thinsp;=\u0026thinsp;0.0, p\u0026thinsp;=\u0026thinsp;0.98) after controlling for parental SES.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult/adulthood\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIndividuals 16\u0026ndash;24 years: Individuals with poor mental health were less likely to progress from basic education to short education (men: unadjusted HR: 0.72, 95% confidence interval (CI): 0.62\u0026ndash;0.85; women: unadjusted HR: 0.87, 95% CI: 0.79\u0026ndash;0.96).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eShort education to medium/long education: Women (aged 16\u0026ndash;24 years) with poor mental health were less likely to progress from short education to medium/long education (unadjusted HR: 0.75; 95% CI: 0.62\u0026ndash;0.90). Men with poor mental health were not significantly less likely to progress from short education to medium/long education (HR: 0.84, 95% CI: 0.61\u0026ndash;1.17).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdults with depression did not have significantly different odds of improving their educational attainment compared with controls (OR: 0.83, 95% 0.51, 1.35, p\u0026thinsp;=\u0026thinsp;0.46).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePoor childhood mental health significantly predicted reduced likelihood of getting a degree after controlling for maternal mental health, maternal education and parental social class (b: -0.023, SE: 0.005, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSellers et al. [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIn two different cohorts (ALSPAC and NCDS), children with mental health problems were less likely to go on to achieve a least five good exam passes than children without mental health problems (boys: NCDS: OR: 0.49, 95% CI: 0.31, 0.78, p\u0026thinsp;=\u0026thinsp;0.003, ALSPAC: OR: 0.30, 95% CI: 0.22, 0.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; girls: NCDS: OR: 0.50, 95% CI: 0.32, 0.76, p\u0026thinsp;=\u0026thinsp;0.010, ALSPAC: OR: 0.34, 95% CI: 0.23, 0.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (no parental SES adjustment).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eOffspring mental health at age 18 was significantly associated with educational attainment at age 30 (b: 0.018, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIn people with disability, controlling for gender and parental levels of education, poor mental health increased the chances of low levels of educational attainment (b: 0.136, SE: 0.019, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eCase et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMental health or emotional problems at age 16 were associated with a reduced number of \u0026lsquo;O\u0026rsquo; level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16, mental problems at age 7 (b:-0.637, SE: 0.123, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eMental health or emotional problems at age 7 were also associated with a reduced number of \u0026lsquo;O\u0026rsquo; level passes when controlling for family income at age 16, prenatal smoking, height, physical impairments at age 7 and age 16 and mental impairments at age 16 (b: = -0.601, SE: 0.128, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"9\" rowspan=\"10\"\u003e \u003cdiv class=\"SimplePara\"\u003eIncome\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntergenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s income (F\u0026thinsp;=\u0026thinsp;0.03, p\u0026thinsp;=\u0026thinsp;0.87) after controlling for parental SES.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eWorse mental health in mothers predicted reduced household income for their children at age 30 (b:-0.036, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eWhen controlling for child mental health at age 10, the association of mothers\u0026rsquo; mental health with reduced income for their children at age 30 became weaker but remained significant (b:-0.021, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Child and maternal mental health interacted to predict offspring income.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eParental depression did not predict personal income (b: -0.01, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) when controlling for fathers\u0026rsquo; job level or job percentile\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntragenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression was not a significant predictor of income after controlling for parental SES (F\u0026thinsp;=\u0026thinsp;0.95, p\u0026thinsp;=\u0026thinsp;0.33)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression had significantly reduced odds of increasing their annual income over 5 years compared with controls (OR: 0.67, 95% CI: 0.46, 0.97, p\u0026thinsp;=\u0026thinsp;0.03).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression did not have significantly different odds of decreasing their annual income over 5 years compared with controls (OR: 1.26, 95% CI: 0.69, 2.27, p\u0026thinsp;=\u0026thinsp;0.45).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIncome in adulthood was predicted by depressive symptoms.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eLower initial levels and faster decrease over time in depressive symptoms were associated with higher income in adulthood (controlling for parental/childhood SES).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnxiety disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eOlder adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eGroffen et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eOlder adults with a social anxiety disorder had increased odds of a decrease in income after adjusting for gender, age, educational attainment, baseline income and change in occupational status (OR: 1.69, 95% CI: 1.15, 2.50, p\u0026thinsp;\u0026lt;\u0026thinsp;0.008).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e Social anxiety disorder was related to a decrease in income regardless of educational attainment or income levels at baseline: these variables did not moderate the association (p\u0026thinsp;=\u0026thinsp;0.68).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eJohnston et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eChildhood mental health does not predict adulthood income after controlling for maternal mental health, maternal education and parental social class (b:-0.010 SE: 0.008, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eAdulthood mental health predicts adulthood income after controlling for maternal mental health, maternal education and parental social class \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e(b:-0.083, SE: 0.008, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSareen et al. [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eThere were no significant relationships between baseline mental health problems and change in income status during the 3-year follow-up period (statistics not reported).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression had a small negative effect on income percentile at 10-year follow-up (b:\u0026minus;0.10, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"16\" rowspan=\"17\"\u003e \u003cdiv class=\"SimplePara\"\u003eOccupation\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntergenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eParents\u0026rsquo; depression was not a significant predictor of their children\u0026rsquo;s occupation (F\u0026thinsp;=\u0026thinsp;1.13, p\u0026thinsp;=\u0026thinsp;0.29), after controlling for parental SES.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence/adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eThere was no direct association between mothers\u0026rsquo; mental health and their children\u0026rsquo;s occupational status in adulthood (b: 0.08, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eHowever, mothers\u0026rsquo; mental health was significantly associated with their children\u0026rsquo;s mental health in adolescence (b: 0.22, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). This child variable significantly predicts occupational status (b: 0.19, 0\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eParents\u0026rsquo; depression did not predict their children\u0026rsquo;s occupation (b: 0.00, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) when controlling for fathers\u0026rsquo; job level or job percentile.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"13\" rowspan=\"14\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntragenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eButterworth et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] (Good quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMen with poor mental health were significantly more likely to become unemployed (b: 0.21, SE: 0.04, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and be unemployed for longer (b: 0.14, SE: 0.04 p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) compared with men with better mental health.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eWomen with poor mental health are significantly more likely to become unemployed (b: 0.14, SE: 0.03, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), but were not more likely to be unemployed for longer (b: 0.04, SE: 0.03, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eRitsher et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] (Good quality)\u003csup\u003ea\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression was not a significant predictor of occupation after controlling for parental SES (F\u0026thinsp;=\u0026thinsp;1.07, p\u0026thinsp;=\u0026thinsp;0.30).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAmos et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with treatment-resistant depression were 2.3 times more likely than employees without depressive disorders (HR: 2.29 95% CI: 1.44, 3.65, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) to switch to COBRA status (changed occupational status with reduced hours) during follow-up. \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eThere was significant difference between cohorts for employment termination (results not shown). \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with treatment-resistant depression were 1.4 times more likely than employees without depressive disorders (HR: 1.37, 95% CI: 1.11, 1.69, p\u0026thinsp;=\u0026thinsp;0.004) to either switch to COBRA status or terminate employment.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAro et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMen and women with major affective disorder had a 2.5\u0026ndash;3.9 times and 2.8\u0026ndash;4.2 times higher risk, respectively, of becoming unemployed than the general population.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eYoung adult/adulthood\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eChristensen et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIndividuals in employment who experience poor mental health were more likely to become unemployed than those with good mental health (adjusted for education level and long-term illness, men aged 25\u0026ndash;44 HR:3.74, 95% CI: 2.65\u0026ndash;3.86, women aged 25\u0026ndash;44: 2.79, 95% CI: 2.48\u0026ndash;3.14, men aged 45\u0026ndash;59 HR: 3.32, 95% CI: 2.83, 3.89, women aged 45\u0026ndash;59 HR: 3.13, 95% CI: 2.72\u0026ndash;3.61).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eIndividuals who are not employed with poor mental health were less likely to become employed (adjusted for education level, long term illness, smoking behaviour, alcohol consumption, BMI, physical activity, men aged 25\u0026ndash;44 HR: 0.56, 95% CI: 0.44\u0026ndash;0.72, women aged 25\u0026ndash;44 HR: 0.47, 95% CI: 0.39\u0026ndash;0.58, men aged 45\u0026ndash;59 HR: 0.50, 95% CI:0.38\u0026ndash;0.67, women aged 45\u0026ndash;59 HR: 0.43, 95% CI: 0.32, 0.59).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eCoryell et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression had significantly reduced odds of being employed in the previous year compared with controls (OR: 0.57, 95% CI: 0.39, 0.84, p\u0026thinsp;=\u0026thinsp;0.004).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression had significantly reduced odds of improving their occupation over their lifetime best in the previous 5 years compared with controls (prevalence ratio [PR]: 0.45, 95% CI: 0.29, 0.69, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression had significantly increased odds of decreasing their occupational status from their lifetime best in the previous 5 years compared with controls (OR: 1.89, 95% CI: 1.31, 2.73, p\u0026thinsp;=\u0026thinsp;0.001).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eElovainio et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eOccupational status in adulthood was predicted by depressive symptoms. \u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eLower initial levels and faster decrease over time in depressive symptoms were associated with higher occupational status in adulthood (controlling for parental/childhood SES).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdolescence/Adult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eHalonen et al. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eSymptoms of mental health problems were not associated with increased odds of becoming employed at a different age, controlling for parental education and household income, compared with age\u0026thinsp;\u0026gt;\u0026thinsp;24: being age 19\u0026ndash;23: OR: 1.01 95% CI: 0.84, 1.23, p\u0026thinsp;=\u0026thinsp;0.919), being age\u0026thinsp;\u0026lt;\u0026thinsp;18: OR: 0.76 95% CI: 0.61, 0.95, p\u0026thinsp;=\u0026thinsp;0.015)\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eSymptoms of mental health problems were also not associated with a specific occupational class obtained during first employment. Low occupational class compared with intermediate: OR: 0.95 95% CI: 0.74, 1.22, p\u0026thinsp;=\u0026thinsp;0.688); non-specified compared with intermediate: OR: 0.93 95% CI: 0.73, 1.20, p\u0026thinsp;=\u0026thinsp;0.567).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eSlominski et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eOffspring mental health at age 18 significantly predicted occupational status at age 30 (b: 0.19, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eTolman et al. [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] (Fair quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eSymptoms of social anxiety disorder in the preceding month significantly predicted the number of months worked (b:-0.114 SE: 0.054, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eSymptoms of depressive disorder in the preceding month did not significantly predict the number of months worked (b:-0.012 SE: 0.031, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eAbebe et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eIn people with a physical disability, controlling for gender and parental education, poor mental health increased the chances of unemployment (b: 0.067, SE: 0.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eEaton et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepression at baseline did not predict job percentile at 10-year follow-up (b\u0026thinsp;=\u0026thinsp;0.05, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05, data not shown)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eLandstedt et al. [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] (poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive symptoms did not predict employment trajectories after controlling for occupational status.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eMen: \u0026lsquo;medium\u0026rsquo;\u003csup\u003ec\u003c/sup\u003e education into stable employment: OR: 0.44 95% CI: 0.18, 1.10, p\u0026thinsp;=\u0026thinsp;0.075; \u0026lsquo;short\u0026rsquo; education into stable employment OR: 0.85 95% CI: 0.38, 1.90, p\u0026thinsp;=\u0026thinsp;0.692; continuously unstable situation: OR: 2.20 95% CI: 0.90, 5.46, p\u0026thinsp;=\u0026thinsp;0.086.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eWomen: \u0026lsquo;short\u0026rsquo; education into stable employment OR: 1.69 95% CI: 0.66, 4.38, p\u0026thinsp;=\u0026thinsp;0.277; continuously unstable situation: OR: 1.92 95% CI: 0.64, 5.80, p\u0026thinsp;=\u0026thinsp;0.246.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eDepressive disorders\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003ePrause et al. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] (poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eMore severe depression was not associated with decreased odds of employment 2 years later in those who were unemployed at baseline (OR:\u0026nbsp;1.04, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), and in those who were underemployed at baseline (OR:\u0026nbsp;1.04, p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The gap between employment rates of men and women did however decrease with increasing symptoms of depression.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSocial mobility\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntragenerational\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eAny common mental health problem\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdult\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eBirtchnell [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] (Poor quality)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeople with depression showed significantly less upward social mobility (change in social class from parents) than people without depression in classes IV and V.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Systematic Review, Social Mobility, Mental health, Common Mental Disorder, Socio-economic Factors","lastPublishedDoi":"10.21203/rs.3.rs-2656092/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2656092/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e The aim of this systematic review was to identify published evidence on the association between common mental disorders (CMDs), changes in socioeconomic outcomes, and social mobility.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Systematic literature searches were conducted across seven databases up to May 2022. Quantitative studies were included based on the following criteria: 1) cohort study design, 2) the population had a common mental disorder, 3) Outcomes reported related to social mobility and social class (due to the limited direct measures of social mobility and social class, changes in socioeconomic outcomes were included as proxies of social mobility). The identified studies were analysed using narrative synthesis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThere was more evidence for the negative intragenerational than intergenerational association of CMDs on educational attainment, income, and occupational status. Considering the intergenerational association on educational attainment, there was an association between parental mental health disorders on parent-child interactions which subsequently affects their child’s mental health. This in turn may negatively impact their child’s educational progression. Only one study investigated the direct association of CMDs with changes in social class and subsequent social mobility.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Given the evidence of the negative intragenerational association between CMDs and socioeconomic outcomes, it is important to promote mental health interventions adapted to the work and educational environment that adequately equip individuals to maintain their own mental health. Additionally, within the home environment, there is a need to further understand how negative parent-child interactions impact a child’s mental health and develop strategies to mitigate how this may impact subsequent social mobility.\u003c/p\u003e","manuscriptTitle":"The association between common mental disorders, socioeconomic outcomes and social mobility: A systematic review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-11 19:41:39","doi":"10.21203/rs.3.rs-2656092/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9a742620-9424-4529-8f90-1096f4862fc6","owner":[],"postedDate":"January 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-07T15:07:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-11 19:41:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2656092","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2656092","identity":"rs-2656092","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}