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Depression and mortality: artifact of measurement and analysis?

K M Appleton1, J V Woodside2, D Arveiler3

  • 1Psychology, DEC, Bournemouth University, Dorset BH12 5BB, United Kingdom.

Journal of Affective Disorders
|August 17, 2013
PubMed

Insights

This study found that the association between depression and mortality depends on how depression is measured and analyzed. Using validated scales is recommended over factor analysis for clearer results in depression and mortality research.

Area of Science:

  • Cardiovascular health
  • Mental health research
  • Epidemiology

Background:

  • Previous research shows mixed results on the link between depression and cardiovascular disease (CVD) outcomes.
  • Methodological differences in measuring depression and analyzing data may explain these discrepancies.

Purpose of the Study:

  • To investigate the association between depression and CVD incidence, and mortality from CVD, smoking-related conditions, and all causes.
  • To compare findings using a validated depression measure versus a factor analysis-derived measure, and continuous versus grouped data analysis.

Main Methods:

  • Analysis of data from 9798 men in the PRIME Study.
  • Utilized Cox proportional hazards models to assess 10-year CVD incidence and mortality.
  • Employed two methods for measuring depression: a validated questionnaire and factor analysis.

Main Results:

  • Continuous data analysis revealed positive associations between both depression measures and all-cause mortality, CVD mortality, and smoking-related mortality.
  • Grouped data analysis showed a loss of association between a validated depression measure and CVD mortality.
  • Factor analysis-derived depression measures lost all associations with mortality when using grouped data.

Conclusions:

  • The detection of an association between depression and mortality is highly dependent on the measurement tools and analytical methods employed.
  • Findings suggest that validated depression scales are preferable, and over-reduction through factor analysis or data grouping should be avoided.
  • Methodological variations present challenges in understanding the complex relationship between depression and mortality.
Abstract

Keywords:
Cardiovascular diseaseDepressionMethodologyMortalityQuestionnairesStatistical analysis

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