Predictors of long-term prognosis of depression

Colman, Ian; Naicker, Kiyuri; Zeng, Yiye; Ataullahjan, Anushka; Senthilselvan, Ambikaipakan; Patten, Scott B.

doi:10.1503/cmaj.110676

Cited by 86 publications

(66 citation statements)

References 28 publications

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“…Sixth, we did not have information on all demographic factors, including family income, to include as covariates in our study. Income is a risk factor for depression 54,55 and higher religiousness has been associated with higher income level in Canada, 56 therefore, it is possible that income may account for these associations. Last, our study was carried out in a single region of central and northern Nova Scotia, which may limit its generalizability.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Associations of Importance of Religion and Frequency of Service Attendance with Depression Risk among Adolescents in Nova Scotia

et al. 2013

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Objective:To examine the directionality of associations between self-reported religious importance or worship attendance and depression among adolescents, and to determine whether social supports or general self-efficacy are mechanisms of observed associations. Method:A cohort (n = 976) of Canadian high school students were surveyed in Grade 10 (2000 to 2001) and 2 years later (2002 to 2003). Logistic regression was conducted separately among adolescents with and without elevated depressive symptoms to examine associations between baseline religious attendance and religious importance with later depression, adjusting for confounding factors. Effects of reverse causation were also assessed, determining associations between baseline depression and follow-up religious attendance and importance.Results: Girls who were not depressed at baseline and who attended religious services had lower odds of later depression (adjusted odds ratio [AOR] 0.46; 95% CI 0.22 to 0.95, P < 0.05), which was accounted for by general self-efficacy. Boys who were depressed at baseline who attended religious services had lower odds of still being depressed at followup (AOR 0.23; 95% CI 0.06 to 0.80, P < 0.01). Depression at baseline predicted lower attendance at follow-up among boys (AOR 0.26; 95% CI 0.09 to 0.75, P < 0.01). Conclusions:Religious attendance independently predicts lower depression at followup among girls, and may do so by increasing self-efficacy. Among boys with depression, religious attendance predicts a lower likelihood of still being depressed at follow-up. The relation between religious attendance and depression in boys is bidirectional. W W W Associations longitudinales de l'importance de la religion et de la fréquence de la pratique du culte avec le risque de dépression chez des adolescents de la Nouvelle-ÉcosseObjectif : Examiner la directionnalité des associations entre l'importance auto-déclarée de la religion ou de la pratique du culte et la dépression chez les adolescents, et déterminer si les soutiens sociaux ou l'auto-efficacité générale sont des mécanismes des associations observées.Méthode : Une cohorte (n = 976) d'élèves du secondaire canadiens a été interrogée en 10e année (2000 à 2001) et 2 ans plus tard (2002 à 2003). La régression logistique a été menée séparément chez des adolescents présentant ou pas des symptômes dépressifs élevés afin d'examiner les associations entre la pratique religieuse de départ et l'importance de la religion avec la dépression ultérieure, en corrigeant les facteurs de confusion. Les effets de la causalité inverse ont aussi été évalués, en déterminant les associations entre la dépression au départ et la pratique et l'importance de la religion au suivi.Résultats : Les filles qui n'étaient pas déprimées au départ et qui pratiquaient leur religion avaient des probabilités plus faibles d'une dépression ultérieure (rapport de cotes corrigé [RCC] 0,46; IC à 95 % 0,22 à 0,95; P < 0,05), ce qui était attribué à l'auto-efficacité générale. Les garçons qui étaient déprimés au départ et qu...

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Section: Discussionmentioning

confidence: 99%

Longitudinal Associations of Importance of Religion and Frequency of Service Attendance with Depression Risk among Adolescents in Nova Scotia

et al. 2013

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“…8 The accuracy of family physicians in predicting the course of depression is described as fair, 9 although as in other conditions it has been studied relatively little. Useful predictors of poor depression outcome in primary care have been identified in 3 main areas: individual characteristics (age, 10 high neuroticism levels, 11 perceived need for care, 12 low mastery 13 ); socioeconomic status (low education level, 12 low income, 12 unemployment 12 ); loneliness, 12 low social support, 12,14 limitations of social activities due to health 14 ; and health, both physical (medical comorbidity, 11,12,14,15 chronic pain, 11 daily smoking 13 ) and mental (comorbid anxiGilles Ambresin, MD 1 ety, 11,12,15 double depression, 11 severity of depressive symptoms, 11,12,14,16 somatic symptoms of depression, 16 history of recurrent depression, 15 remission status at 3 months, 15 appropriate use of antidepressant medications, 14 greater mental dysfunction 16 ). Reliable assessment of the predictors listed above requires time and a multitude of validated instruments.…”

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confidence: 99%

Self-Rated Health and Long-Term Prognosis of Depression

Ambresin

Chondros

Dowrick

et al. 2014

The Annals of Family Medicine

125

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PURPOSE Indicators of prognosis should be considered to fully inform clinical decision making in the treatment of depression. This study examines whether self-rated health predicts long-term depression outcomes in primary care. METHODSOur analysis was based on the first 5 years of a prospective 10-year cohort study underway since January 2005 conducted in 30 randomly selected Australian primary care practices. Participants were 789 adult patients with a history of depressive symptoms. Main outcome measures include risks, risk differences, and risk ratios of major depressive syndrome (MDS) on the Patient Health Questionnaire.RESULTS Retention rates during the 5 years were 660 (84%), 586 (74%), 560 (71%), 533 (68%), and 517 (66%). At baseline, MDS was present in 27% (95% CI, 23%-30%). Cross-sectional analysis of baseline data showed participants reporting poor or fair self-rated health had greater odds of chronic illness, MDS, and lower socioeconomic status than those reporting good to excellent self-rated health. For participants rating their health as poor to fair compared with those rating it good to excellent, risk ratios of MDS were 2.10 (95% CI, 1.60-2.76), 2.38 (95% CI, 1.77-3.20), 2.22 (95% CI, 1.70-2.89), 1.73 (95% CI, 1.30-2.28), and 2.15 (95% CI, 1.59-2.90) at 1, 2, 3, 4, and 5 years, after accounting for missing data using multiple imputation. After adjusting for age, sex, multimorbidity, and depression status and severity, self-rated health remained a predictor of MDS up to 5 years.CONCLUSIONS Self-rated health offers family physicians an efficient and simple way to identify patients at risk of poor long-term depression outcomes and to inform therapeutic decision making. INTRODUCTIOND epression is the largest contributor to the burden of disease in high-income countries, and further increases are expected.1,2 Of those who seek professional help for depression, 80% turn to a primary care physician. 3 The high prevalence of depressive symptoms in primary care patients highlights the crucial role of primary care in the detection and treatment of depression. 4,5 In clinical practice understanding the prognosis for an individual is central to fully inform treatment decisions, 6 yet prognosis has received limited attention compared with therapeutic and etiological research. 6,7 Validated prognostic indices provide estimates of the probability of an outcome for those with a particular condition 7 and offer improved accuracy in prognostic assumptions that influence clinical decisions. The accuracy of family physicians in predicting the course of depression is described as fair, 9 although as in other conditions it has been studied relatively little. Self-rated health may be a candidate for a simple and transportable prognostic index. It provides a singlequestion assessment of one's subjective health, encompassing physical functioning, as well as psychosocial aspects of health.25,26 Self-rated health has been used as a reliable, quick assessment for population health monitoring. [27][28][29] Two lar...

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“…In a related research article, Colman and colleagues used population-based longitudinal data to try to identify risk factors that predict recurrence. 2 Individuals with recurrent depression tend to have more severe initial episodes and a poorer response to treatment during subsequent recurrences compared with those without recurrent depression. 3 One goal of predicting which patients are likely to experience a recurrence is to identify those who should receive long-term treatment for depression.…”

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confidence: 99%

“…The other reaction is to believe that there is no method beyond that used by Colman and colleagues that can add to our ability to predict recurrence. 2 Data from population-based surveys may be useful for understanding the predictors of recurrence because the samples tend to be more heterogeneous than those derived from clinical populations and therefore may potentially be more representative of the population with the disorder. At the same time, such heterogeneity can lead to at least two major limitations.…”

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confidence: 99%