The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries

Maria Cabello,Paul Kowal,Marta Miret,Somnath Chatterji,Francisco Felix Caballero,Nirmala Naidoo,Catherine D’Este,Jose Luis Ayuso-Mateos

doi:10.1186/s12992-017-0237-5

Abstract

BackgroundUnhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. However, few longitudinal evidence of these relationships has been collected in emerging countries. The present study aims i) to analyse whether people with unhealthy lifestyles are more likely to develop depression, and ii) to examine whether depressed people with unhealthy lifestyles are more likely to remain depressed. A total of 7908 participants from Ghana, India, Mexico and Russia were firstly evaluated in the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) Wave 0 (2002–2004) and re-evaluated in 2007–2010 (Wave 1). Data on tobacco use, alcohol drinking and physical activity, were collected. Logistic regressions models were employed to assess whether baseline unhealthy lifestyles were related to depression in Wave 1, among people without 12-month depression in Wave 0 and any previous lifetime diagnosis of depression, and to 12-month depression at both study waves (persistent depression).ResultsBaseline daily and non-daily smoking was associated with depression in Wave 1. Low physical activity and heavy alcohol drinking were associated with persistent depression.ConclusionsUnhealthy lifestyles and depression are also positively related in emerging countries. Smoking on a daily and non-daily basis was longitudinally related to depression. Depressed people with low physical activity and with heavy drinking patterns were more likely to become depressed over time. Several interpretations of these results are given. Further studies should check whether a reduction of these unhealthy lifestyles leads to lower depression rates and/or to a better clinical prognosis of depressed people.

Highlights

Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time
The present study provides evidence collected in four emerging countries about the positive relationships between some unhealthy lifestyles and depression
The results of this study together with the studies undertaken in high income countries might support the idea of common mechanisms explaining the relationship between tobacco use and depression across countries

Summary

Introduction

Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. According to World Health Organization (WHO), tobacco use, excessive alcohol drinking and physical inactivity are important modifiable risk factors for mortality and burden in the world [1]. These factors have been traditionally studied in the field of non-communicable diseases such as cancer, diabetes or heart attacks [2]. People who smoke [8] and drink excessively [9] are more likely to become depressed over time This could be explained by the existence of common vulnerable factors independently associated with depression and with unhealthy lifestyles [10, 11]. Tobacco might impact on some biological mechanisms that could increase the likelihood of developing depression [7, 12]

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Conclusion