Abstract
In this study, we aimed to identify the most important and sex-specific social, psychological, behavioral and somatic predictors of recurrent depressive symptoms. Data was obtained at two measurement points within five years by the Gutenberg Health Study (GHS). Out of N = 12,061 individuals, a sample of 877 (age 52.3 ± 9.9) who reported clinically relevant depressive symptoms at baseline was analyzed. Univariate analyses and multiple logistic regression analyses were conducted. Almost half of participants depressed at baseline also reported depressive symptoms five years later. Sex-stratified multivariate analyses revealed that solely social support remained a significant protective predictor against recurrence of depression in men (OR = 0.93; CI95% = 0.87–0.99), whereas in women smoking (OR = 1.97; CI95% = 1.23–3.22), and Type D personality (OR = 1.65; CI95% = 1.10–2.49) were significant risk factors. However, when analyzing the entire sample, no interaction effect between sex and each predictor turned out to be significant. Only social support was retained as an overall predictive factor. As depressive symptoms recur, depressive vulnerability is established involving personality, health behavior and social factors. Although no significant sex-specific interactions were observed, sex-stratified analyses point out different patterns for relevant predictors of recurrent depressive symptoms in men and women.
Highlights
In this study, we aimed to identify the most important and sex-specific social, psychological, behavioral and somatic predictors of recurrent depressive symptoms
Sex failed to reach significance despite of higher amount of women with recurrent depressive symptoms compared to men
Sociodemographic Sex Age socioeconomic status (SES) Living with partner (%) Behavioral Smoking (%) Active sports (%) Alcohol above tolerance (%) Somatic cardiovascular risk disease (CVD) (%) Cancer (%) Diabetes (%) Obesity (%) Psychological Type D personality (%) Life events Loneliness (%) Social support Generalized Anxiety (%) Social phobia (%) Panic (%) History of depression (%) History of anxiety disorder (%) Medication intake Antidepressant (%)
Summary
We aimed to identify the most important and sex-specific social, psychological, behavioral and somatic predictors of recurrent depressive symptoms. In the latest systematic review[7] only five cohorts from two countries were identified investigating risk factors of recurrent depression: These are NESDA and The Netherlands Mental Health Survey and Incidence Study (NEMESIS) in Europe, in the USA the Collaborative Depression Study (CDS), the Group Health Cooperative (GHC) and the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) with a full range of psychiatric characteristics, biological, genetic and neuroimaging variables as potential risk factors for recurrent depression Psychosocial measures such as loneliness and perceived social support were only focused in the Dutch studies which are in particular interest for psychotherapy interventions. Et al.[3] found no effect of demographic variables on recurrent depression in multivariate analyses taking into account smoking, history of depression and mastery
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