Dtsch Arztebl Int. 2025 Oct 17;(Forthcoming):arztebl.m2025.0144. doi: 10.3238/arztebl.m2025.0144. Online ahead of print.

ABSTRACT

BACKGROUND: Economic resources are vital for the formation of individualized living conditions. By definition, persons suffering from absolute poverty live below the minimum standard at which basal life needs can be securely met; relative poverty is characterized by an income level that is no more than 50% or 60% of the median for the population in question. In 2024, 15.5% of persons living in Germany were relatively poor. In this narrative review, we discuss the link between relative poverty and mental illness among adults, children, and adolescents in industrialized countries.

METHODS: We review pertinent studies (2004-2024) of relative poverty and mental illnesses as defined by the ICD or DSM criteria that were retrieved by a search in five scientific databases.

RESULTS: Of the 3038 publications that were initially identified, 44 met the inclusion criteria. They revealed significant associations between relative poverty and mental illness, particularly depression, in adults as well as in children and adolescents. Five of the 44 studies did not demonstrate any association. Attempts were made to explain these associations in various ways; the dominant hypotheses were of a social decline because of mental illness, and of mental illness because of poor social conditions. Both the causation of poverty by mental illness and the causation of mental illness by poverty appear plausible. Combinations of the two explanations are conceivable as well.

CONCLUSION: The findings confirm the association of relative poverty with mental illness, yet the causal relationship remains largely unexplained despite the existence of comprehensive explanatory models. Sociopolitical measures might alleviate mental illnesses or lower their prevalence by reducing socioeconomic inequality.

PMID:40853333 | DOI:10.3238/arztebl.m2025.0144