Predictors of first-episode unipolar major depression in individuals with and without sub-threshold depressive symptoms: A prospective, population-based study

Abstract

Background The aim of this study is to assess predictors of first-episode major depression in a community-based sample of adults with and without sub-threshold depression. Method Data were from Waves 1 & 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Participants meeting criteria for a sub-threshold depressive episode (sMDE; n = 3,901) reported lifetime depressed mood/loss of interest lasting at least two weeks and at least two of the seven other DSM-IV symptoms of MDD. Predictors of MDE 3 years later were compared in those with and without (n = 31,022) sMDE. Results Being female, history of alcohol or substance use, and child abuse increased the odds of developing MDD to a greater degree in individuals without sMDE relative to those with sMDE. Among those with sMDE and additional risk factors (low education, substance use), younger age was associated with marginally increased risk of MDD. Conclusion Several demographic risk factors may help identify individuals at risk for developing MDD in individuals who have not experienced an sMDE who may be candidates for early intervention. Future work should assess whether preventative interventions targeting substance/alcohol use and child abuse could reduce the risk of depression.

The risk of developing major depression among individuals with subthreshold depression: a systematic review and meta-analysis of longitudinal cohort studies

“…Of the 16 studies, 10 used a case definition corresponding with the diagnostic criteria for minor depression (Bruce & Hoff, 1994; Wagner et al 2000; Lyness et al 2002; Cuijpers et al 2004; Forsell, 2007; Jackson et al 2007; Johnson et al 2009; Shankman et al 2009; Peters et al 2015; McLeod et al 2016), three involved experiencing 2–4 depressive symptoms (Horwath et al 1992; Crum et al 1994; Oldehinkel et al 1999) and three involved having elevated scores on a depression rating scale (Beekman et al 2002; Jonsson et al 2011; Jinnin et al 2017). Most studies ( N = 15) used structured clinical interviews that identified cases of major depression based on DSM-III or DSM-IV criteria (Horwath et al 1992; Bruce & Hoff, 1994; Crum et al 1994; Oldehinkel et al 1999; Wagner et al 2000; Beekman et al 2002; Lyness et al 2002; Cuijpers et al 2004; Jackson et al 2007; Johnson et al 2009; Shankman et al 2009; Jonsson et al 2011; Peters et al 2015; McLeod et al 2016; Jinnin et al 2017), with one study by Forsell (2007) using a self-report questionnaire to identify cases of major depression that meet DSM-IV diagnostic criteria.…”

“…Table 1 presents a summary of study design factors for the 16 cohort studies included in the meta-analysis. Of the 16 studies, six involved community-based adult samples ( n = 57 813) (Horwath et al 1992; Bruce & Hoff, 1994; Cuijpers et al 2004; Forsell, 2007; Peters et al 2015; Jinnin et al 2017), five involved community-based youth samples ( n = 4136) (Oldehinkel et al 1999; Johnson et al 2009; Shankman et al 2009; Jonsson et al 2011; McLeod et al 2016), three involved primary care adult samples ( n = 4540) (Crum et al 1994; Wagner et al 2000; Jackson et al 2007), one involved a community-based elderly sample ( n = 604) (Beekman et al 2002) and one involved a primary care elderly sample ( n = 225) (Lyness et al 2002). The average starting age of study participants ranged between 15.0 and 16.6 years in youth samples, 18.3 and 58.9 years in adult samples and 71.1 and 71.8 in elderly samples.…”

“…Furthermore, our study demonstrates that the association between subthreshold depression and the future risk of major depression has a high probability of being positive even after accounting for different sources of study heterogeneity. Lastly, our systematic review identified one new study conducted in youth (McLeod et al 2016) and five new adult studies (Crum et al 1994; Forsell, 2007; Jackson et al 2007; Peters et al 2015; Jinnin et al 2017) to supplement those compiled by previous systematic reviews examining the link between subthreshold depression and major depression (Cuijpers & Smit, 2004; Hermens et al 2004; Bertha & Balazs, 2013; Wesselhoeft et al 2013).…”

Some Predictors of Depressive Disorders in the Context of Clinical Patomorphosis

“…Дослідження особливостей сучасної клінічної феноменології депресивних розладів на ініціальному етапі має важливе значення для розуміння закономірностей та динаміки клінічного патоморфозу депресій, а результати таких досліджень можуть бути покладені в основу розробки сучасних методів прогнозування, лікування та профілактики депресивних розладів [9,10]. Особливо цінними є результати аналізу предикторів первинного епізоду депресивного розладу, оскільки це дає можливість передбачати виникнення захворювання і спрямовувати зусилля на його первинну профілактику; при цьому сьогодні відчувається брак таких досліджень і недостатність інформації щодо преморбідної та ініціальної симптоматики депресій, асоційованої з високим ризиком розвитку афективної патології [11].…”

Interpersonal counselling for adolescent depression delivered by youth mental health workers without core professional training: a feasibility randomised controlled trial study protocol

“…Such mild depression is associated with significant personal and public health consequences [ 4 ] and is a strong predictor for future onset of full [ 5 ]. Sub-threshold depression has a lifetime prevalence rate of 26% [ 6 ] and about 30% of affective disorders that occur in adulthood start in adolescence [ 7 ]. Depression in adolescence predicts a range of adverse outcomes in adulthood, including ongoing mental health problems [ 8 ], poorer physical health [ 9 ], and social, legal and financial problems [ 10 ], and is the most prevalent psychiatric disorder in young people who die by suicide [ 11 ].…”