Importance The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures such as education, income and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture perception of relative social status, but to date there are no studies of associations between SSS and mental disorders. Objective To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS. Design; Setting; Participants Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, the Middle East (n= 56,085). SSS was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, education and occupation. Scores on the 1–10 SSS scale were categorised into four categories: low (scores 1–3); low-mid (scores 4 and 5); high-mid (scores 6 and 7); high (scores 8–10). OSS was assessed with a wide range of fine-grained objective indicators of income, education and occupation. Main Outcome Measures The Composite International Diagnostic Interview assessed 12-month prevalence of 16 DSM-IV mood, anxiety and impulse control disorders. Results Graded, inverse associations were found between SSS and all 16 mental disorders. Gross odds-ratios (lowest versus highest SSS categories) in the range 1.8–9.0 were attenuated but remained significant for all 16 disorders (ORs: 1.4–4.9) after adjusting for OSS indicators. The pattern of inverse association between SSS and mental disorders was significant in 14/18 individual countries, and in low, middle and high income country groups, but was significantly stronger in higher versus lower income countries. Conclusions Significant inverse associations between SSS and numerous DSM-IV mental disorders exist across a wide range of countries even after comprehensive adjustment for OSS. Although unclear whether these associations are due to social selection, social causation, or both, these results document clearly that research relying exclusively on standard OSS measures underestimates the steepness of the social gradient in mental disorders.