Depressive symptoms trajectories among individuals with disabilities living alone in South Korea: a growth mixture modeling approach

BackgroundGiven the rapidly rising proportion of the older population in China and the relatively high prevalence of depressive symptoms among this population, this study aimed to identify the trajectories of depressive symptoms and the factors associated with the trajectory class to gain a better understanding of the long-term course of depressive symptoms in this population.MethodsData were obtained from four wave’s survey of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3646 participants who aged 60 years or older during baseline survey, and completed all follow-ups were retained in this study. Depressive symptoms were measured using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D-10). Growth mixture modelling (GMM) was adopted to identify the trajectory classes of depressive symptoms, and both linear and quadratic functions were considered. A multivariate logistic regression model was used to calculate the adjusted odds ratios (ORs) of the associated factors to predict the trajectory class of participants.ResultsA four-class quadratic function model was the best-fitting model for the trajectories of depressive symptoms in the older Chinese population. The four trajectories were labelled as increasing (16.70%), decreasing (12.31%), high and stable (7.30%), and low and stable (63.69%), according to their trends. Except for the low and stable trajectory, the other trajectories were almost above the threshold for depressive symptoms. The multivariate logistic regression model suggested that the trajectories of chronic depressive symptoms could be predicted by being female, living in a village (rural area), having a lower educational level, and having chronic diseases.ConclusionsThis study identified four depressive symptom trajectories in the older Chinese population and analysed the factors associated with the trajectory class. These findings can provide references for prevention and intervention to reduce the chronic course of depressive symptoms in the older Chinese population.

Maternal symptoms of depression and anxiety during pregnancy and early postnatal years are suggested to impose differential negative effects on child's socio-emotional development depending on the characteristics of the symptoms, such as timing, intensity, and persistence. The aim of this study was to identify trajectories of maternal depressive and anxiety symptoms from pregnancy until 2 years postpartum and to examine their relationship with child socio-emotional problems and competence at 2 and 5 years of age.The sample included 1208 mother-infant dyads from FinnBrain Birth Cohort study. Latent growth mixture modelling (LGMM) was utilized to model the trajectories of maternal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS), and general anxiety, measured with Symptom Checklist-90 (SCL-90) at 14, 24, and 34 weeks' gestation (gw) and at 3, 6 and 24 months postpartum. Maternal depression was also assessed at 12 months. Child socio-emotional problems and competence were evaluated using the Brief Infant Toddler Social Emotional Assessment (BITSEA) at 2 years and Strengths and Difficulties Questionnaire (SDQ) at 5 years. Relevant background factors and maternal concurrent symptomatology were controlled for.The trajectories of maternal depressive and anxiety symptoms were associated negatively with differential aspects of child long term socio-emotional outcomes from early toddlerhood to preschool years. The trajectories of depressive symptoms and high-level persistent symptoms that continued from pregnancy to two years of child age had the strongest negative association with child outcomes. This highlights the importance of identifying and treating maternal symptomatology, especially that of depression, as early as possible.

The role of bullying in depressive symptoms from adolescence to emerging adulthood: A growth mixture model

Few studies have explored the trajectories of Chinese early adolescent depressive symptoms or comprehensively considered the factors of family and peers. The present study aimed to identify the trajectories of depressive symptoms in early adolescence using a school-based sample assessed in three waves. The study also examined whether family and peer factors were significant predictors. A total of 586 Chinese primary and middle school students participated in the survey. A growth mixture model was used to find the trajectories of depressive symptoms, and multinominal logistic regression was used to identify the predictors. Three trajectories were identified, including a stable-low class, an increasing class, and a high-decreasing class. Results indicated that gender, parental psychological aggression and neglect, parental psychological control, traditional bullying/cyberbullying victimization, and friendship quality were significant predictors. However, witnessing intimate partner violence, parental behavior control, and traditional bullying/cyberbullying perpetration could not significantly predict the trajectories. The findings of this study can provide an empirical basis for teachers and clinical interveners to determine different development trajectories of depressive symptoms and carry out prevention and intervention.

BACKGROUNDDepression is a significant risk factor for diabetes, particularly type 2 diabetes. However, depressive symptoms differ from clinical depression. Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIMTo investigate the association between depressive symptoms, their trajectories, and the risk of developing diabetes in two prospective cohort studies.METHODSIn the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study (HRS). Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later. We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase. Finally, we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing (ELSA) as a validation study. Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores: Persistently high; increasing; fluctuating; decreasing; and persistently low. Diabetes mellitus was defined as self-reported, physician-diagnosed diabetes. Cox proportional hazards models were used to assess hazard ratios (HR) and 95% confidence intervals (CI), adjusting for potential confounders.RESULTSIn the first phase a total of 27658 participants were included (HRS: 18633, ELSA: 9025), among whom 6582 had depressive symptoms (HRS: 4547, ELSA: 2035), 6407 had somatic depressive symptoms (HRS: 4414, ELSA: 1993), and 26415 had cognitive-affective depressive symptoms (HRS: 17755, ELSA: 8660). We found that overall depressive symptoms (HRS: HR = 1.14, 95%CI: 1.07-1.22; ELSA: HR = 1.18, 95%CI: 1.03-1.34) and somatic depressive symptoms (HRS: HR = 1.14, 95%CI: 1.07-1.22; ELSA: HR = 1.25, 95%CI: 1.10-1.42) increased the risk of diabetes, while cognitive depressive symptoms were not associated with diabetes risk. Over an 8-year follow-up we identified 19729 trajectories of overall, somatic, and cognitive-affective depressive symptoms (HRS: 13918, ELSA: 5811). In the second phase we found that persistently high (HRS: HR = 1.22, 95%CI: 1.06-1.40, ELSA: HR = 1.54, 95%CI: 1.16-2.05 in total and HRS: HR = 1.24, 95%CI: 1.07-1.43, ELSA: HR = 1.79, 95%CI: 1.36-2.35 in somatic) and fluctuating (HRS: HR = 1.09, 95%CI: 1.01-1.17, ELSA: HR = 1.33, 95%CI: 1.14-1.55 in total and HRS: HR = 1.10, 95%CI: 1.02-1.18, ELSA: HR = 1.31, 95%CI: 1.13-1.53 in somatic) trajectories of overall and somatic depressive symptoms increased the risk of diabetes, while increasing trajectories may also raise diabetes risk. However, decreasing trajectories were not associated with diabetes risk. Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes. Sensitivity analyses confirmed the reliability of the findings.CONCLUSIONPersistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes, while decreasing trajectories were not associated with diabetes risk. In contrast trajectories of cognitive-affective depressive symptoms show no relationship with diabetes risk. Focusing on depressive symptom trajectories, particularly those of somatic depressive symptoms, represented a viable strategy for future diabetes prevention.

This study draws from a life-course perspective in examining trajectories of mothers' depressive symptoms across their adolescent daughters' adjustment to parenthood in 204 Mexican-origin families using latent class growth analysis. Four distinct trajectories were identified based on mothers' depressive symptoms before the birth and 10 and 24 months postpartum. Two trajectories were characterized by stable levels of depressive symptoms but were differentiated in their levels of symptoms (i.e., High/Stable and Low/Stable). The remaining two trajectories were characterized by changes from pre- to post-birth, with one group exhibiting increases in depressive symptoms (i.e., Low/Post-Birth Increase) and the other group characterized by decreases in depressive symptoms (i.e., Low/Post-Birth Decrease). Consistent with a risk and resilience perspective, mothers with more disadvantaged socioeconomic circumstances and fewer intrapersonal resources (i.e., self-esteem, ethnic identity affirmation) were more likely to be members of the High/Stable group. In addition, daughters of mothers in the High/Stable group were more likely to have lower self-esteem as compared with daughters in the other three groups. Collectively, these findings suggested that the High/Stable group was at risk for adjustment difficulties from the third trimester to two years postpartum. In contrast, membership in the Low/Post-Birth Decrease trajectory group was associated with lower depressive symptoms and higher self-esteem for mothers and daughters. Findings point to the need to identify mothers who are at risk for depressive symptoms during their adolescent daughters' pregnancy and offer prevention and intervention programs that reduce risks and enhance protective factors.

e24144 Background: Depressive symptoms are common among women undergoing chemotherapy (CTX) for breast or gynecological cancer. Many studies have examined the prevalence of depressive symptoms (usually at the beginning or end of CTX). However, given that CTX unfolds over a number of cycles, there is a need to better understand patterns of change in depressive symptoms over the course of treatment, and to identify factors that may predispose individuals to worse symptom trajectories. The purpose of this study, among women who underwent CTX for breast or gynecological cancer, was to evaluate for interindividual differences in depressive symptoms over the course of two cycles of CTX, and to identify characteristics associated with both initial levels (i.e., at the beginning of the study) and trajectories of depressive symptoms. Methods: Patients undergoing CTX for breast (n = 530) or gynecologic (n = 233) cancer completed the Center for Epidemiological Studies-Depression (CES-D) questionnaire six times over two treatment cycles. Patient-reported measures were used to assess demographic, clinical, symptom, stress, and coping characteristics at enrollment. Using hierarchical linear modeling (HLM), we evaluated characteristics associated with initial levels and trajectories of depressive symptoms. Results: One demographic (marital status) and two clinical (number of comorbidities, functional status) characteristics predicted interindividual differences in initial levels of depressive symptoms. One demographic (education) and one clinical (MAX-2 score, a CTX toxicity metric) characteristic were associated with interindividual differences in depressive symptom trajectories. Several symptom characteristics predicted interindividual differences in initial levels (i.e., morning fatigue), trajectories (i.e., initial level of depression), or both initial levels and trajectories (i.e., sleep disturbance, attentional function) of depressive symptoms. Two stress-related variables (i.e., perceived stress, cancer-related distress) predicted interindividual differences in both initial levels and trajectories of depressive symptoms. Several coping variables predicted interindividual differences in initial levels (i.e., behavioral disengagement), trajectories (i.e., venting), or both initial levels and trajectories (i.e., self-blame) of depressive symptoms. Conclusions: The range of demographic, clinical, symptom, stress and coping characteristics associated with interindividual differences in depressive symptoms underscores the importance of evaluating risk and protective factors. These factors may serve as useful markers for both screening and intervention to address depressive symptoms during CTX.

Antepartum depression is a prevalent unhealthy mental health problem worldwide, particularly in low-income countries. It is a major contributor to adverse birth outcomes. Previous studies linking antepartum depression to birthweight have yielded conflicting results, which may be reason that the depressive symptoms were only measured once during pregnancy. This study aimed to explore the associations between trajectories of antepartum depressive symptoms and birthweight. Depressive symptoms were assessed prospectively at each trimester in 3699 pregnant women from 24 hospitals across 15 provinces in China, using the Edinburgh Postpartum Depression Scale (EPDS). Higher scores of EPDS indicated higher levels of depressive symptoms. Associations between trajectories of depressive symptoms and birthweight were examined using group-based trajectory modeling (GBTM), propensity score-based inverse probability of treatment weighting (IPTW), and logistic regression. GBTM identified five trajectories. Compared with the low-stable trajectory of depressive symptoms, only high-stable (OR = 1.35, 95% CI: 1.15-2.52) and moderate-rising (OR = 1.18, 95% CI: 1.12-1.85) had an increased risk of low birthweight (LBW) in the adjusted longitudinal analysis of IPTW. There was no significant increase in the risk of LBW in moderate-stable and high-falling trajectories. However, trajectories of depressive symptoms were not associated with the risk of macrosomia. Antepartum depressive symptoms were not constant. Trajectories of depressive symptoms were associated with the risk of LBW. It is important to optimize and implement screening, tracking, and intervention protocols for antepartum depression, especially for high-risk pregnant women, to prevent LBW. This article is protected by copyright. All rights reserved.

The trajectories of the associations of physical activity (PA) with depressive symptoms in postmenopausal women are still unclear. This study aimed to identify the joint trajectories of PA and depressive symptoms over a 5-year period among Chinese postmenopausal women and to comprehensively examine their associations and predictors. The study included 1303 postmenopausal women who participated in the China Health and Retirement Longitudinal Survey (CHARLS) between 2015, 2018 and 2020. Depressive symptoms were measured by CESD-10. PA was assessed by the IPAQ-SF. Group-based dual trajectory modeling (GBDTM) was applied to examine the joint trajectories of PA and depressive symptoms in postmenopausal women. Quantile regression assessed their associations within trajectory groups, and a multinomial logistic model identified group predictors. Three distinct dual trajectories of PA and depressive symptoms were identified in postmenopausal women: moderate stable-low increase (32.0%), high curve-moderate increase (46.1%), and low stable-high increase (21.9%), all showing a worsening trend in depressive symptoms. Consistent moderate PA was accompanied by low slightly increased depressive symptoms. Low PA was positively associated with high depressive symptoms in the 10th and 30th quantiles. High PA initially suppressed depressive symptoms, but its inhibitory effect diminished as symptoms worsened. Predictors of latent trajectory groups included rural residence, uneducated, insufficient sleep, and comorbidities. Screening for depressive symptoms in postmenopausal women is necessary, especially in those with long-term low PA. PA interventions should be tailored according to the severity and trajectory of depressive symptoms.

BackgroundMost evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors.MethodsWe analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors.Results1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had persistent high depressive symptoms, followed by mothers with moderate symptoms (early postpartum and subclinical trajectories) and lowest for minimal symptoms. After accounting for demographic, child and psychosocial factors, the relationships between depression trajectories and child hyperactivity/inattention, physical aggression (subclinical trajectory only) and separation anxiety symptoms remained significant.ConclusionThese findings suggest both externalizing and internalizing children’s behaviors are associated with prolonged maternal depressive symptoms. There is a good case for the need to move beyond overly simplistic clinical cutoff approaches of depressed/not depressed in screening for perinatal depression. Women with elevated depressive symptoms at clinical and subclinical levels need to be identified, provided with evidence-based treatment, and monitored with repeat screening to improve maternal mental health outcomes and reduce the risk of associated negative outcomes on children’s early social-emotional and behavior development.

Parental and individual predictors of trajectories of depressive symptoms in Chilean adolescents

BackgroundMaternal depression may be chronic and recurrent, with negative effects both on the health of mothers and children. Many studies have shown trajectories of postnatal depressive symptoms but few studies in low- and middle-income countries have evaluated the trajectories of depressive symptoms starting during pregnancy. This study aims to identify the different trajectories of depressive symptoms among mothers in the Pelotas 2015 birth cohort, from pregnancy to the second year of the child’s life.MethodsThis study used data from the 2015 Pelotas Birth Cohort, a longitudinal study of all live births occurred in 2015 in Pelotas, Brazil. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers who completed the EPDS on at least three follow-up visits beginning to the antenatal follow-up visit were included in the analyses. The trajectory of maternal depressive symptoms was estimated through group-based trajectory modeling.ResultsA total of 3040 women were included in the present analysis. We identified five groups of maternal depressive symptoms trajectories, with 23.4% of the mothers presenting persistent depressive symptoms and 3.9% showing chronic high depressive symptoms throughout the study period. The probability of having persistent depressive symptoms increased among mothers with greater socioeconomic vulnerability.ConclusionsThis study shown the persistence of maternal depressive symptoms since pregnancy until 2 years postnatal. Additionally, alongside the known risk factors, pre-gestational depression and antenatal depressive symptoms are important risk factors for the persistence and severity of depressive symptoms. These findings support the need to provide mental health evaluation and care for women from pregnancy to the late postnatal period.

Relatively little is known about whether the association between smoking and depressive symptoms changes with age and how the trajectories of smoking and depressive symptoms are intertwined during the life course. In this population-based study, these associations were examined from young adulthood to middle age. Participants of a Finnish cohort study (N = 1955) were assessed at the ages of 22, 32, 42, and 52 using questionnaires covering daily smoking (yes/no) and the short 13-item Beck Depression Inventory. Longitudinal latent class and longitudinal latent profile analyses were used to identify life course trajectories of smoking and depressive symptoms. The proportions of daily smokers decreased, while levels of depressive symptoms increased among both females and males from age 22 to 52 years. Smoking was associated with higher levels of depressive symptoms from age 22 to 42 years, while not at 52. Associations among males prevailed when adjusting for education, marital status, and alcohol use. Four life course classes of daily smoking (nonsmokers, decreasing prevalence of smoking, persistent smokers, and increasing prevalence of smoking) and four trajectories of depressive symptoms (low, increasing/moderate, decreasing/moderate, and high) were identified. In males, persistent daily smokers (relative risk ratio (RRR) = 4.5, 95% confidence interval (CI): 2.2 to 9.2) and those in the class with increasing smoking prevalence (RRR = 3.2, 95% CI: 1.1 to 9.1) had an increased risk of belonging to the high depressive symptoms profile. In females these associations were nonsignificant. Compared to females, the relationship between smoking and depressive symptoms seems more robust among males during adulthood. Specifically, males smoking persistently from young adulthood to middle age have an increased risk of high depressive symptoms trajectory. This population-based cohort with 30 years of follow-up showed that the life course trajectories of daily smoking and depressive symptoms are associated. Persistent daily smokers and those starting late had an increased risk of belonging to the profile with constantly high levels of depressive symptoms during the life course. However, these associations were statistically significant only in males. Actions should be strengthened, especially in males, to prevent smoking initiation, to help smoking cessation, and to identify and treat depression in smokers with significant depressive symptoms.

BACKGROUNDDepressive symptoms differ from clinical depression. However, the relationship between depressive symptom trajectories and stroke risk across diverse geographic regions remains unclear.AIMTo address the gap in the existing understanding of the relationship between depressive symptom trajectories and stroke risk, the current study utilized three representative cohorts.METHODSIn this study, we used three representative cohorts from Asia, Europe, and the Americas: China Health and Retirement Longitudinal Study (CHARLS), English Longitudinal Study of Ageing (ELSA), and Health and Retirement Study (HRS). Depressive symptoms were assessed using the 8-item Center for Epidemiological Studies Depression scale and categorized into somatic and cognitive-affective subtypes. The trajectories of depressive symptoms were monitored over four surveys starting from baseline and classified into five distinct states: persistently low, decreasing, fluctuating, increasing, and consistently high. Self-reported physician diagnoses were used to evaluate the subsequent stroke events. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) were computed using Cox proportional-risk models adjusted for potential confounding factors.RESULTSA total of 7990 participants from CHARLS (females: 52.3%, mean age: 63.4 years), 5642 participants from ELSA (females: 56.2%, mean age: 63.7 years), and 12260 participants from HRS (females: 61.4%, mean age: 64.7 years) participated in this study. The median follow-up periods were 5 years for CHARLS, 8 years for ELSA, and 10 years for HRS. In comparison with the persistently low trajectory, consistently high and fluctuating trajectories of total depressive symptoms increased the risk of stroke in all three cohorts (CHARLS: HR = 1.80, 95%CI: 1.36-2.38; ELSA: HR = 1.50, 95%CI: 1.02-2.21; HRS: HR = 1.45, 95%CI: 1.29-1.62 for consistently high; CHARLS: HR = 1.47, 95%CI: 1.14-1.90; ELSA: HR = 1.44, 95%CI: 1.17-1.77; HRS: HR = 1.26, 95%CI: 1.13-1.41 for fluctuating). Increasing trajectories enhanced the risk in the European cohort (ELSA: HR = 1.71, 95%CI: 1.06-2.74), while decreasing trajectories did not increase stroke risk in any cohort. For somatic depressive symptoms, consistently high and fluctuating trajectories increased the risk of stroke across all cohorts (CHARLS: HR = 2.16, 95%CI: 1.67-2.79; ELSA: HR = 1.94, 95%CI: 1.34-2.81; HRS: HR = 1.79, 95%CI: 1.49-2.15 for consistently high; CHARLS: HR = 1.35, 95%CI: 1.20-1.62; ELSA: HR = 1.56, 95%CI: 1.27-1.92; HRS: HR = 1.33, 95%CI: 1.20-1.46 for fluctuating). Increasing trajectories only increased the risk in the European cohort (ELSA: HR = 1.95, 95%CI: 1.11-3.43), while decreasing trajectories did not increase stroke risk in the European and American cohorts. For cognitive-affective depressive symptoms, consistently high and fluctuating trajectories increased the risk in the Asian and European cohorts (CHARLS: HR = 2.06, 95%CI: 1.52-2.81; ELSA: HR = 1.25, 95%CI: 1.02-1.54 for consistently high; CHARLS: HR = 1.63, 95%CI: 1.23-2.16; ELSA: HR = 1.58, 95%CI: 1.11-2.24 for fluctuating). Increasing trajectories increased the risk only in the American cohort (HRS: HR = 14.67, 95%CI: 1.87-114.91).CONCLUSIONConsistently high and fluctuating trajectories of total and somatic depressive symptoms were associated with an increased risk for stroke across all populations. Consistently high, fluctuating, and increasing trajectories of cognitive-affective symptoms pose a risk for certain populations. These findings highlight the importance of targeted interventions for managing depressive symptoms as potential strategies for stroke prevention, particularly in regions where specific symptom trajectories are prevalent.

Less favorable trajectories of depressive mood from adolescence to early adulthood are associated with current and later psychopathology, impaired educational attainment, and social dysfunction, yet the genetic and environmental risk factors associated with these trajectories are not fully established. Examining what risk factors are associated with different trajectories of depressive mood could help identify the nature of depression symptoms and improve preventive interventions for those at most risk. To examine the differential associations of genetic and environmental risk factors with trajectories of depression symptoms among individuals observed from ages 10 to 24 years. In a longitudinal cohort study established in 1990 and currently ongoing (the Avon Longitudinal Study of Parents and Children [ALSPAC]), growth mixture modeling was used to identify trajectories of depression symptoms in 9394 individuals in the United Kingdom. Associations of different risk factors with these trajectories were then examined. Analysis was conducted between August 2018 and January 2019. Trajectories were composed from depression symptoms measured using the Short Mood and Feelings Questionnaire at 9 occasions from ages 10 to 24 years. Risk factors included sex, a polygenic risk score taken from a recent genome-wide association study of depression symptoms, maternal postnatal depression, partner cruelty to the offspring's mother when the child was aged 2 to 4 years, childhood anxiety at age 8 years, and being bullied at age 10 years. Data on all risk factors, confounders, and the outcome were available for 3525 individuals, including 1771 (50.2%) who were female. Trajectories were assessed between the mean (SD) age of 10.7 (0.3) years and mean (SD) age of 23.8 (0.5) years. Overall, 5 distinct trajectories of depression symptoms were identified: (1) stable low (2506 individuals [71.1%]), (2) adolescent limited (325 individuals [9.2%]), (3) childhood limited (203 individuals [5.8%]), (4) early-adult onset (393 individuals [11.1%]), and (5) childhood persistent (98 individuals [2.8%]). Of all the associations of risk factors with trajectories, sex (odds ratio [OR], 6.45; 95% CI, 2.89-14.38), the polygenic risk score for depression symptoms (OR, 1.47; 95% CI, 1.10-1.96), and childhood anxiety (OR, 1.30; 95% CI, 1.16-1.45) showed the strongest association with the childhood-persistent trajectory of depression symptoms compared with the stable-low trajectory. Maternal postnatal depression (OR, 2.39; 95% CI, 1.41-4.07) had the strongest association with the early-adult-onset trajectory, while partner cruelty to mother (OR, 2.30; 95% CI, 1.36-3.90) had the strongest association with the adolescent-limited trajectory. Bullying (OR, 8.08; 95% CI, 4.92-13.26) showed the strongest association with the childhood-limited trajectory. The least favorable trajectories of depression symptoms (childhood persistent and early-adult onset) were associated with both genetic and environmental risk factors, but the 2 trajectories of limited duration that had resolved by early adulthood (childhood limited and adolescent limited) were not associated with the polygenic risk score or maternal postnatal depression. Bullying was strongly associated with both the childhood-persistent and childhood-limited trajectories, suggesting that this risk factor may have a time-specific effect. These findings suggest that examining genetic and multiple time-specific environmental antecedents could help identify trajectories of varying onset and chronicity.