History of depression and women's current health and functioning during midlife

To examine the association of past depression with current physical and mood symptoms and functioning in a community cohort of middle-aged African-American, White, and Hispanic women without current depression and whether the associations varied by severity of prior depression.

The study was conducted as part of a longitudinal multisite investigation of middle-aged women's health, the Study of Women's Health Across the Nation (SWAN). Nine hundred twenty-two women, aged 42-52 years, participated in The Structured Clinical Interview for the Diagnosis of DSM-IV Axis I Disorders (SCID) at study entry at three SWAN sites; 780 did not have current depression and formed the analytic sample. chi(2), ANOVAs and Cochran-Armitage Trend tests were conducted as appropriate to evaluate bivariate relationships between history of major depression and covariates and outcomes. Multivariable logistic regression analyses included significant covariates in final analyses.

Women (24.3%) had a history of major depression: 14.9% single episode, 9.4% recurrent and 12.6% had minor depression. In multivariable logistic regression analyses, compared to no history of depression, any past depression predicted high body pain [odds ratios (ORs), 1.8-2.3; 95% CIs, 1.05-4.02]. Recurrent depression predicted poor social functioning (OR, 2.1; 95% CI, 1.20-3.80) and current treatment for back pain (OR, 4.2; 95% CI, 1.78-9.82). Minor depression predicted mood symptoms (OR, 1.9; 95% CI, 1.16-3.20).

Midlife women with past major or minor depression are at risk for physical symptoms, body pain, and poor social functioning even in the absence of current depression. Primary care providers may underestimate the health impact of prior depression without current depression.