Association of sense of coherence with DSM-IV mental disorders in a general population sample

Objectives. The aim of the study was to analyse the association of Antonovsky's Sense of Coherence (SOC) concept and mental health on grounds of DSM-IV diagnoses in the general population. Methods. Data stem from a representative cross-sectional general population survey in northern Germany. Data from 4 005 subjects who completed the Orientation to Life Questionnaire were available. A computer-assisted personal diagnostic interview was conducted to obtain DSM-IV Axis I disorders. Results. Individuals with DSM-IV axis I disorders showed lower SOC-scores than those without the respective disorders, also after moderating variables like sex or socio-economic status (OR = 0.97; 95% CI = 0.96-0.97 for lifetime, OR = 0.96; 95% CI = 0.96-0.97 for 12 months). Of the 433 persons with the lowest 10% of the SOC distribution, 214 (49.4%) fulfilled criteria for a 12-month diagnosis while 56 (12.4%) of the subjects with the highest SOC scores did so (χ² = 142.6; df = 1, p < 0,001). Of the 900 persons in the lowest income group, 65 (7.2%) scored in the highest 10% of the SOC distribution and 11 fulfilled 12 months criteria for a diagnosis. Conclusions. Data from this study support the existence of a relationship between Sense of Coherence and mental health in the general population even after controlling for possible intervening variables. SOC and mental disorders form independent aspects of mental health, and in persons subjected to high life stress, SOC may serve as a protecting agent against mental disorders.