Investigating the impact of poverty on mental illness in the UK Biobank using Mendelian randomization

Mattia Marchi, Anne Alkema, Charley Xia, Chris H. L. Thio, Li-Yu Chen, Winni Schalkwijk, Gian M. Galeazzi (), Silvia Ferrari, Luca Pingani, Hyeokmoon Kweon, Sara Evans-Lacko, W. David Hill and Marco P. Boks ()
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Mattia Marchi: University of Modena and Reggio Emilia
Anne Alkema: University Utrecht
Charley Xia: University of Edinburgh
Chris H. L. Thio: University Medical Centre Groningen
Li-Yu Chen: University Utrecht
Winni Schalkwijk: University Utrecht
Gian M. Galeazzi: University of Modena and Reggio Emilia
Silvia Ferrari: University of Modena and Reggio Emilia
Luca Pingani: University of Modena and Reggio Emilia
Hyeokmoon Kweon: Vrije Universiteit Amsterdam
Sara Evans-Lacko: London School of Economics and Political Science
W. David Hill: University of Edinburgh
Marco P. Boks: University Utrecht

Nature Human Behaviour, 2024, vol. 8, issue 9, 1771-1783

Abstract: Abstract It is unclear whether poverty and mental illness are causally related. Using UK Biobank and Psychiatric Genomic Consortium data, we examined evidence of causal links between poverty and nine mental illnesses (attention deficit and hyperactivity disorder (ADHD), anorexia nervosa, anxiety disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder and schizophrenia). We applied genomic structural equation modelling to derive a poverty common factor from household income, occupational income and social deprivation. Then, using Mendelian randomization, we found evidence that schizophrenia and ADHD causally contribute to poverty, while poverty contributes to major depressive disorder and schizophrenia but decreases the risk of anorexia nervosa. Poverty may also contribute to ADHD, albeit with uncertainty due to unbalanced pleiotropy. The effects of poverty were reduced by approximately 30% when we adjusted for cognitive ability. Further investigations of the bidirectional relationships between poverty and mental illness are warranted, as they may inform efforts to improve mental health for all.

Date: 2024
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DOI: 10.1038/s41562-024-01919-3

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