Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T23:21:57.278Z Has data issue: false hasContentIssue false

New onset of depression in aging women and men: contributions of social, psychological, behavioral, and somatic predictors in the community

Published online by Cambridge University Press:  22 August 2018

Manfred E. Beutel*
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Elmar Brähler
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Joerg Wiltink
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Jasmin Ghaemi Kerahrodi
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Juliane Burghardt
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Matthias Michal
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Andreas Schulz
Affiliation:
Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Phillipp S. Wild
Affiliation:
Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Germany Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Germany DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany
Thomas Münzel
Affiliation:
Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Germany DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany Center for Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Irene Schmidtmann
Affiliation:
Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Germany
Karl J. Lackner
Affiliation:
Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Norbert Pfeiffer
Affiliation:
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Andreas Borta
Affiliation:
Boehringer Ingelheim Pharma GmbH Co KG, Ingelheim am Rhein, Germany
Ana N. Tibubos
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
*
Author for correspondence: Manfred E. Beutel, E-mail: manfred.beutel@unimedizin-mainz.de

Abstract

Background

Based on the vulnerability–stress model, we aimed to (1) determine new onset of depression in individuals who had not shown evidence of depression at baseline (5 years earlier) and (2) identify social, psychological, behavioral, and somatic predictors.

Methods

Longitudinal data of N = 10 036 participants (40–79 years) were evaluated who had no evidence of depression at baseline based on Patient Health Questionnaire (PHQ-9), no history of depression, or intake of antidepressants. Multivariate logistic regression models were used to predict the onset of depression.

Results

Prevalence of new cases of depression was 4.4%. Higher rates of women (5.1%) than men (3.8%) were due to their excess incidence <60 years of age. Regression analyses revealed significant social, psychological, behavioral, and somatic predictors: loneliness [odds ratio (OR) 2.01; 95% confidence interval (CI) 1.48–2.71], generalized anxiety (OR 2.65; 1.79–3.85), social phobia (OR 1.87; 1.34–2.57), panic (OR 1.67; 1.01–2.64), type D personality (OR 1.85; 1.47–2.32), smoking (OR 1.35; 1.05–1.71), and comorbid cancer (OR 1.58; 1.09–2.24). Protective factors were age (OR 0.88; 0.83–0.93) and social support (OR 0.93; 0.90–0.95). Stratified by sex, cancer was predictive for women; for men smoking and life events. Entered additionally, the PHQ-9 baseline score was strongly predictive (OR 1.40; 1.34–1.47), generalized anxiety became only marginally, and panic was no longer predictive. Other predictors remained significant, albeit weaker.

Conclusions

Psychobiological vulnerability, stress, and illness-related factors were predictive of new onset of depression, whereas social support was protective. Baseline subclinical depression was an additional risk weakening the relationship between anxiety and depression by taking their overlap into account. Vulnerability factors differed between men and women.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aziz, R and Steffens, DC (2013) What are the causes of late-life depression? The Psychiatric Clinics of North America 36, 497516.Google Scholar
Barlow, DH, Sauer-Zavala, S, Carl, JR, Bullis, JR and Ellard, KK (2013) The nature, diagnosis, and treatment of neuroticism. Clinical Psychological Science 2, 344365.Google Scholar
Bernardini, F, Attademo, L, Cleary, SD, Luther, C, Shim, RS, Quartesan, R and Compton, MT (2017) Risk prediction models in psychiatry: toward a new frontier for the prevention of mental illnesses. Journal of Clinical Psychiatry 78, 572583.Google Scholar
Beutel, ME, Brahler, E, Wiltink, J, Michal, M, Klein, EM, Junger, C, Wild, PS, Munzel, T, Blettner, M, Lackner, K, Nickels, S and Tibubos, AN (2017 a) Emotional and tangible social support in a German population-based sample: development and validation of the Brief Social Support Scale (BS6). PLoS ONE 12, e0186516.Google Scholar
Beutel, ME, Klein, EM, Brahler, E, Reiner, I, Junger, C, Michal, M, Wiltink, J, Wild, PS, Munzel, T, Lackner, KJ and Tibubos, AN (2017 b) Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry 17, 97.Google Scholar
Beutel, ME, Wiltink, J, Kirschner, Y, Sinning, C, Espinola-Klein, C, Wild, PS, Munzel, T, Blettner, M, Zwiener, I, Lackner, K and Michal, M (2014) History of depression but not current depression is associated with signs of atherosclerosis: data from the Gutenberg Health Study. Psychological Medicine 44, 919925.Google Scholar
Bogren, M, Brådvik, L, Holmstrand, C, Nöbbelin, L and Mattisson, C (2017) Gender differences in subtypes of depression by first incidence and age of onset: a follow-up of the Lundby population. European Archives of Psychiatry and Clinical Neuroscience 268, 179189.Google Scholar
Cabello, M, Miret, M, Caballero, FF, Chatterji, S, Naidoo, N, Kowal, P, D'este, C and Ayuso-Mateos, JL (2017) The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries. Globalization and Health 13, 18.Google Scholar
Cooney, GM, Dwan, K, Greig, CA, Lawlor, DA, Rimer, J, Waugh, FR, Mcmurdo, M and Mead, GE (2013) Exercise for depression. Cochrane Database of Systematic Reviews, Sep12 (9): CD004366.Google Scholar
Coplan, JD, Aaronson, CJ, Panthangi, V and Kim, Y (2015) Treating comorbid anxiety and depression: psychosocial and pharmacological approaches. World Journal of Psychiatry 5, 366378.Google Scholar
Cuijpers, P, Vogelzangs, N, Twisk, J, Kleiboer, A, Li, J and Penninx, BW (2013) Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both. The British Journal of Psychiatry 202, 2227.Google Scholar
Davoudi, M, Omidi, A, Sehat, M and Sepehrmanesh, Z (2017) The effects of acceptance and commitment therapy on man smokers’ comorbid depression and anxiety symptoms and smoking cessation: a randomized controlled trial. Addiction and Health 9, 129138.Google Scholar
Denollet, J (2005) DS14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine 67, 8997.Google Scholar
Gibb, BE, Chelminski, I and Zimmerman, M (2007) Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and anxiety disorders in adult psychiatric outpatients. Depression and Anxiety 24, 256263.Google Scholar
Goodwin, GM (2015) The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in Clinical Neuroscience 17, 249260.Google Scholar
Green, BH, Copeland, JR, Dewey, ME, Sharma, V, Saunders, PA, Davidson, IA, Sullivan, C and Mcwilliam, C (1992) Risk factors for depression in elderly people: a prospective study. Acta Psychiatrica Scandinavica 86, 213217.Google Scholar
Groffen, DA, Koster, A, Bosma, H, Van Den Akker, M, Kempen, GI, Van Eijk, JT, Van Gool, CH, Penninx, BW, Harris, TB, Rubin, SM, Pahor, M, Schulz, R, Simonsick, EM, Perry, SE, Ayonayon, HN, Kritchevsky, SB and Health, ABCS (2013) Unhealthy lifestyles do not mediate the relationship between socioeconomic status and incident depressive symptoms: the Health ABC study. The American Journal of Geriatric Psychiatry 21, 664674.Google Scholar
Hardeveld, F, Spijker, J, De Graaf, R, Nolen, WA and Beekman, ATF (2010) Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatrica Scandinavica 122, 184191.Google Scholar
Hartung, TJ, Brahler, E, Faller, H, Harter, M, Hinz, A, Johansen, C, Keller, M, Koch, U, Schulz, H, Weis, J and Mehnert, A (2017) The risk of being depressed is significantly higher in cancer patients than in the general population: prevalence and severity of depressive symptoms across major cancer types. European Journal of Cancer 72, 4653.Google Scholar
Hobson, CJ and Delunas, L (2001) National norms and life-event frequencies for the Revised Social Readjustment Rating Scale. International Journal of Stress Management 8, 299314.Google Scholar
Kemp, AH, Arias, JA and Fisher, Z (2017) Social ties, health and wellbeing: a literature review and model. In Ibáñez, A, Sedeño, L and García, AM (eds), Neuroscience and Social Science: The Missing Link. Cham: Springer International Publishing, pp. 397410.Google Scholar
Kendler, KS, Karkowski, LM and Prescott, CA (1999) Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837841.Google Scholar
Kendler, KS, Myers, J and Prescott, CA (2005) Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs. American Journal of Psychiatry 162, 250256.Google Scholar
Kendler, KS, Thornton, LM and Prescott, CA (2001) Gender differences in the rates of exposure to stressful life events and sensitivity to their depressogenic effects. American Journal of Psychiatry 158, 587593.Google Scholar
Klein, DN, Kotov, R and Bufferd, SJ (2011) Personality and depression: explanatory models and review of the evidence. Annual Review of Clinical Psychology 7, 269295.Google Scholar
Kohlmann, S, Gierk, B, Hilbert, A, Brahler, E and Lowe, B (2016) The overlap of somatic, anxious and depressive syndromes: a population-based analysis. Journal of Psychosomatic Research 90, 5156.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JB, Monahan, PO and Lowe, B (2007) Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine 146, 317325.Google Scholar
Kuehner, C (2017) Why is depression more common among women than among men? The Lancet Psychiatry 4, 146158.Google Scholar
Lampert, T, Kroll, L, Müters, S and Stolzenberg, H (2009) [Measurement of the socioeconomic status within the German Health Update 2009 (GEDA)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 56, 131143.Google Scholar
Lorant, V, Deliege, D, Eaton, W, Robert, A, Philippot, P and Ansseau, M (2003) Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 157, 98112.Google Scholar
Lowe, B, Grafe, K, Zipfel, S, Spitzer, RL, Herrmann-Lingen, C, Witte, S and Herzog, W (2003) Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, a screening question, and physicians’ diagnosis. Journal of Psychosomatic Research 55, 515519.Google Scholar
Lowe, B, Grafe, K, Zipfel, S, Witte, S, Loerch, B and Herzog, W (2004) Diagnosing ICD-10 depressive episodes: superior criterion validity of the Patient Health Questionnaire. Psychotherapy and Psychosomatics 73, 386390.Google Scholar
Peters, T, Brage, S, Westgate, K, Franks, PW, Gradmark, A, Diaz, MJT, Huerta, JM, Bendinelli, B, Vigl, M, Boeing, H, Wendel-Vos, W, Spijkerman, A, Benjaminsen-Borch, K, Valanou, E, Guillain, BD, Clavel-Chapelon, F, Sharp, S, Kerrison, N, Langenberg, C, Arriola, L, Barricarte, A, Gonzales, C, Grioni, S, Kaaks, R, Key, T, Khaw, KT, May, A, Nilsson, P, Norat, T, Overvad, K, Palli, D, Panico, S, Quiros, JR, Ricceri, F, Sanchez, MJ, Slimani, N, Tjonneland, A, Tumino, R, Feskens, E, Riboli, E, Ekelund, U, Wareham, N and Consortium, I (2012) Validity of a short questionnaire to assess physical activity in 10 European countries. European Journal of Epidemiology 27, 1525.Google Scholar
Rajan, TM and Menon, V (2017) Psychiatric disorders and obesity: a review of association studies. Journal of Postgraduate Medicine 63, 182190.Google Scholar
Rodriguez, MR, Nuevo, R, Chatterji, S and Ayuso-Mateos, JL (2012) Definitions and factors associated with subthreshold depressive conditions: a systematic review. BMC Psychiatry 12, 181.Google Scholar
Scully, JA, Tosi, H and Banning, K (2000) Life event checklists: revisiting the social readjustment rating scale after 30 years. Educational and Psychological Measurement 60, 864876.Google Scholar
Spangenberg, L, Forkmann, T, Brahler, E and Glaesmer, H (2011) The association of depression and multimorbidity in the elderly: implications for the assessment of depression. Psychogeriatrics 11, 227234.Google Scholar
Spijker, J, De Graaf, R, Bijl, RV, Beekman, ATF, Ormel, J and Nolen, WA (2004) Determinants of persistence of major or depressive episodes in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of Affective Disorders 81, 231240.Google Scholar
Starr, LR, Stroud, CB and Li, YI (2016) Predicting the transition from anxiety to depressive symptoms in early adolescence: negative anxiety response style as a moderator of sequential comorbidity. Journal of Affective Disorders 190, 757763.Google Scholar
Timm, C, Ubl, B, Zamoscik, V, Ebner-Priemer, U, Reinhard, I, Huffziger, S, Kirsch, P and Kuehner, C (2017) Cognitive and affective trait and state factors influencing the long-term symptom course in remitted depressed patients. PLoS ONE 12, e0178759.Google Scholar
Vrshek-Schallhorn, S, Stroud, CB, Mineka, S, Hammen, C, Zinbarg, RE, Wolitzky-Taylor, K and Craske, MG (2015) Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults. Journal of Abnormal Psychology 124, 918932.Google Scholar
Wild, P, Zeller, T, Beutel, ME, Blettner, M, Dugi, K, Lackner, K, Pfeiffer, N, Münzel, T and Blankenberg, S (2012) [The Gutenberg Health Study]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 55, 824829.Google Scholar
Wiltink, J, Beutel, ME, Till, Y, Ojeda, FM, Wild, PS, Munzel, T, Blankenberg, S and Michal, M (2011) Prevalence of distress, comorbid conditions and well being in the general population. Journal of Affective Disorders 130, 429437.Google Scholar
Wiltink, J, Kliem, S, Michal, M, Subic-Wrana, C, Reiner, I, Beutel, ME, Brahler, E and Zwerenz, R (2017) Mini-Social Phobia Inventory (mini-SPIN): psychometric properties and population based norms of the German version. Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie 63, 115115.Google Scholar
Supplementary material: File

Beutel et al. supplementary material

Tables S1-S3

Download Beutel et al. supplementary material(File)
File 31 KB