Major depression as a risk factor for chronic disease incidence: longitudinal analyses in a general population cohort

• Published in: General hospital psychiatry 2008-09, Vol.30 (5), p.407-413
• Main Authors: Patten, Scott B., M.D., Ph.D, Williams, Jeanne V.A., M.Sc, Lavorato, Dina H., M.Sc, Modgill, Geeta, B.A, Jetté, Nathalie, M.D., Ph.D, Eliasziw, Michael, Ph.D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Arthritis; Back pain; Biological and medical sciences; Bronchitis; Canada; Cataracts; Chronic Disease - epidemiology; Chronic Disease - psychology; Cohort Studies; Cross-Sectional Studies; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Depressive disorders; Emphysema; Female; Glaucoma; Health Surveys; Heart disease; Humans; Hypertension; Incidence; Longitudinal Studies; Major depressive episode; Male; Medical sciences; Middle Aged; Migraines; Mood disorders; Peptic ulcers; Proportional Hazards Models; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychophysiologic Disorders - diagnosis; Psychophysiologic Disorders - epidemiology; Psychophysiologic Disorders - psychology; Risk Factors; Thyroid disease; Young Adult
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2008.05.001

Abstract Objective Cross-sectional studies have consistently reported associations between major depression (MD) and chronic medical conditions. Such studies cannot clarify whether medical conditions increase the risk for MD or vice versa. The latter possibility has received relatively little attention in the literature. In this study, we evaluate the incidence of several important chronic medical conditions in people with and without MD. Method The data source was the Canadian National Population Health Survey (NPHS). The NPHS included the Composite International Diagnostic Interview Short Form to assess past-year major depressive episodes. The NPHS also collected self-report data about professionally diagnosed long-term medical conditions. A longitudinal cohort was interviewed every 2 years between 1994 and 2002. Proportional hazards models were used to compare the incidence of chronic conditions in respondents with and without MD and to produce age-, sex- and covariate-adjusted estimates of the hazard ratios. Results The adjusted hazard ratios associated with MD at baseline interview were elevated for several long-term medical conditions: heart disease (1.7), arthritis (1.9), asthma (2.1), back pain (1.4), chronic bronchitis or emphysema (2.2), hypertension (1.7) and migraines (1.9). The incidences of cataracts and glaucoma, peptic ulcers and thyroid disease were not higher in respondents with MD. Conclusion A set of conditions characterized particularly by pain, inflammation and/or autonomic reactivity has a higher incidence in people with MD.