e29Abstracts / Comprehensive Psychiatry 54 (2013) e15–e40

Background: One of the most replicated findings in psychiatricepidemiology is the inverse relationship between psychopathology andsocioeconomic status (SES). Despite this abundance of descriptiveepidemiology, the underlying reason for the social patterning of commonforms of psychopathology, specifically major depression (MD), remainslargely unresolved. There are three competing hypotheses that couldproduce this inverse association: First, social causation, which argues lowerSES in young adulthood is associated with increased exposure to stress andadversity, which are established causes of MD; in this model SES is theantecedent to MD. Second, social drift, which argues that individuals withMD (or genetic liability for MD) are less likely to move out of (or morelikely to move into) low SES over the life course; in this model MD is theantecedent to low SES in adulthood. Third, the common cause model arguesthat some third factor increases risk for both MD and low SES in adulthood;in this model there is no direct relation between SES and MD, rather thecorrelation between them is entirely attributable to this common (genetic orenvironmental) factor. With a handful of notable exceptions, to date fewstudies have examined these competing hypotheses comprehensively in asingle sample.Objective: To test competing hypotheses regarding the origin ofsocioeconomic disparities in MD and determine whether the relationshipbetween socioeconomic status and MD varies by genetic liability for MD.Methods: Data come from a population-based sample of female twins (N:2153). Logistic regression and structural equation twin models were used toevaluate the relative importance of these competing hypotheses.Results: Consistent with the social causation hypothesis, education (OR:0.78, p b 0.01) and income (OR: 0.93, p b 0.01) were significantly relatedto past year MD. Upward social mobility (indicated by greater educationalattainment relative to parents) was associated with lower risk of MD. Therewas no evidence that childhood SES - a common social cause - was relatedto development of MD (OR: 0.98, p N 0.10). Consistent with a commongenetic cause, a modest negative genetic correlation was found between MDand education (r2: −0.22.). Co-twin control analyses indicated a protectiveeffect of education and income on MD even after accounting for geneticliability.Discussion: This genetically-informative study addresses the fundamentallysociological question as to how social position relates to MD, anddemonstrates conceptual and methodological aspects of examining thejoint action and interaction of genetic propensity and the environment.

http://dx.doi.org/10.1016/j.comppsych.2013.07.041

Temperament and character profiles of Japanese university studentswith depressive episodes and suicidality: a PHQ-9 screening study

N. Mitsuia, S. Asakuraa, Y. Shimizua, Y. Fujiia, Y. Kakoa, T. Tanakaa,K. Obaa, T. Inouea, I. KusumiaaSapporo, Hokkaido, Japan

Background: Accordingly, it is very important to study depression andsuicidality in young adults to prevent suicide. Several studies have examinedthe pathogenic and predictive role of personality in depressive symptomsamong the young adult population using the Temperament and CharacterInventory (TCI). The TCI is a widely used self-rating scale for assessingpersonality. However, few studies, at least among the young adult population,have analyzed the association between personality and suicidality. Our recentstudy demonstrated that young adults who completed suicide consistently hadhighHA scores. The association between suicidality and character profiles hasnot yet been studied among the young adult population.Methods: The subjects of this study were 1421 university students whocompleted the Patient Health Questionnaire (PHQ-9) and the Temperamentand Character Inventory (TCI). The subjects were divided into three separategroups: the major depressive episode group (N = 41), the other depressiveepisode group (N = 97), and the non-depressive controls (N = 1283). Thisseparation was achieved using the PHQ-9 algorithm diagnosis. We comparedthe TCI scores using an analysis of variance. Moreover, the Cochran-Armitage

trend test was used to determine the diagnosis, suicidality, and analysis ofcharacter profiles.Results: The major depressive episode group had significantly higher HA(P b 0.001), lower RD (P b 0.001), lower SD (P b 0.001), and lower C(P b 0.001) scores than non-depressive controls. The other depressive episodegroup had significantly higher HA scores (P b 0.001) and lower SD scores(P b 0.001) than non-depressive controls. The Cochran-Armitage trend testrevealed that the prevalence of depressive episodes decreased as the characterprofiles matured (χ2

trend = 57.2, P b 0.0001). The same tendency wasobserved in individuals who had suicidality (χ2

trend = 49.3, P b 0.0001).Conclusion: HighHA scores, low RD scores, low SD scores and low C scoreswere prevalent in young adults who had major depressive episodes. High HAscores and low SD scores were also common in our major and other depressiveepisode groups. Character profiles have a strong impact on the prevalence ofmajor depressive episodes, depressive episodes and suicidal ideation.

http://dx.doi.org/10.1016/j.comppsych.2013.07.042

Losing faith and finding religion: effects of change in religiosity overthe life course on substance use

Arden Moscatia, Briana Mezuka,baVirginia Institute of Psychiatric and Behavioral Genetics,Virginia Commonwealth University School of MedicinebDepartment of Epidemiology and Community Health,Virginia Commonwealth University School of Medicine

Religion has shaped our history for thousands of years, but has only recentlycome into the light of scientific inquiry as a factor thatmay influence health andbehavior, particularly substance use and misuse. Whether religious affiliationinfluences behavior depends not only on the particular mandates of its tenets,but also upon the level of religious belief, or religiosity. While religiosity hasbroadly been found to be negatively associated with substance misuse,religious beliefs are not a time-invariant construct, andmost extant studies havenot explicitly examined how changes in religiosity are related to substance useoutcomes. Using data from the National Comorbidity Survey – Replication(N = 6211), a large nationally representative survey, we examined how levelsof religiosity, including change in religiosity from childhood to adulthood,relate to use and DSM-V abuse/dependence of licit (alcohol and nicotine) andillicit drugs. Religiosity (in childhood and adulthood) was indexed by self-reported importance of religious beliefs measured on a 4-point scale rangingfrom 1 – very important to 4 – not at all important. In general, religiosity wasinversely associated with use and misuse of both licit and illicit substances.However, the relationship between religiosity in adulthood and substance usevaried by level of religiosity in childhood. For example, relative to those withthe same level of religiosity in childhood as in adulthood, a 2-unit decrease inreligiosity was associated with an increased odds ratio of 1.62 (95%Confidence Interval: 1.16–2.27) for use of illicit drugs; similarly, a 2-unitincrease in religiosity from childhood to adulthoodwas associatedwith an oddsratio of 1.92 (95%C.I.: 1.51–2.44) for illicit drug use. Comparable results werefound for changes in religiosity and younger age at first alcohol use, lifetimetobacco use, and substance abuse/dependence. Findings support the use of alife course approach to understanding the relationship between religiosity andsubstance use outcomes.

http://dx.doi.org/10.1016/j.comppsych.2013.07.043

Real-world functioning in schizophrenia: pathways betweenneurocognition, social cognition, and functional competence

Giovanna M. Mussoa,b, Christopher R. Bowiec, Pamela DeRossea,b,Katherine E. Burdickd, Anil K. Malhotraa,baThe Zucker Hillside Hospital, Glen Oaks, NYbFeinstein Institute for Medical Research, Manhasset, NYcQueen's University, Kingston, ONdMount Sinai School of Medicine, New York, NY