Depressive symptoms and neuroticism-related traits are the main factors associated with wellbeing independent of the history of lifetime depression in the UK Biobank.

Chiara Fabbri,Alessandro Serretti,Cathryn M Lewis,Julian Mutz

doi:10.1017/s003329172100502x

Chiara Fabbri, Alessandro Serretti + Show 2 more

Open Access

https://doi.org/10.1017/s003329172100502x

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Abstract

Wellbeing has a fundamental role in determining life expectancy and major depressive disorder (MDD) is one of the main modulating factors of wellbeing. This study evaluated the modulators of wellbeing in individuals with lifetime recurrent MDD (RMDD), single-episode MDD (SMDD) and no MDD in the UK Biobank. Scores of happiness, meaningful life and satisfaction about functioning were condensed in a functioning-wellbeing score (FWS). We evaluated depression and anxiety characteristics, neuroticism-related traits, physical diseases, lifestyle and polygenic risk scores (PRSs) of psychiatric disorders. Other than individual predictors, we estimated the cumulative contribution to FWS of each group of predictors. We tested the indirect role of neuroticism on FWS through the modulation of depression manifestations using a mediation analysis. We identified 47 966, 21 117 and 207 423 individuals with lifetime RMDD, SMDD and no MDD, respectively. Depression symptoms and personality showed the largest impact on FWS (variance explained ~20%), particularly self-harm, worthlessness feelings during the worst depression, chronic depression, loneliness and neuroticism. Personality played a stronger role in SMDD. Anxiety characteristics showed a higher effect in SMDD and no MDD groups. Neuroticism played indirect effects through specific depressive symptoms that modulated FWS. Physical diseases and lifestyle explained only 4-5% of FWS variance. The PRS of MDD showed the largest effect on FWS compared to other PRSs. This was the first study to comprehensively evaluate the predictors of wellbeing in relation to the history of MDD. The identified variables are important to identify individuals at risk and promote wellbeing.

Highlights

Wellbeing is a complex concept that includes physical, mental and social components, which are associated with life expectancy (Ni et al, 2020)
We identified 47 966, 21 117 and 207 423 individuals with lifetime recurrent MDD (RMDD), single-episode MDD (SMDD) and no major depressive disorder (MDD), respectively, having at least two measures included in the functioning-wellbeing score (FWS)
Depression subtypes that were associated with lower FWS were anxious MDD and MDD with atypical neurovegetative symptoms, in participants with SMDD compared to RMDD

Summary

Introduction

Wellbeing is a complex concept that includes physical, mental and social components, which are associated with life expectancy (Ni et al, 2020). In studies conducted in the general population, the most common way to measure wellbeing is through life evaluations, using life satisfaction questions and questions asking how happy people are with their lives (Helliwell, 2019) These studies have identified a number of variables associated with wellbeing, in particular social support, personality characteristics, chronic diseases such as psychiatric disorders and obesity, lifestyle and socioeconomic status (Helliwell, 2019; Santini et al, 2020; Spittlehouse, Vierck, Pearson, & Joyce, 2014; Stranges, Samaraweera, Taggart, Kandala, & Stewart-Brown, 2014). Several clinical features were associated with worse prognosis of MDD, including the duration of the depressive episode and total duration of the illness, suicidality, anxiety and physical diseases such as cardiovascular disease and diabetes (Kraus, Kadriu, Lanzenberger, Zarate, & Kasper, 2019). The identified variables are important to identify individuals at risk and promote wellbeing

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