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Published on: October 24, 2018
Cognitive ability in childhood and the chronicity and suicidality of depression
Galen Chin-Lun Hung1, Stefanie A Pietras1, Hannah Carliner1
1Galen Chin-Lun Hung, MD, ScM, Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taiwan, Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Stefanie A. Pietras, SM, Mathematica Policy Research, Cambridge, Massachusetts, USA; Hannah Carliner, ScD, MPH, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA; Laurie Martin, ScD, MPH, RAND Corporation, Santa Monica, California, USA; Larry J. Seidman, PhD, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, and Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Stephen L. Buka, ScD, Department of Epidemiology, Brown University, Providence, Rhode Island, USA; Stephen E. Gilman, ScD, Department of Social and Behavioral Sciences and Department of Epidemiology, Harvard School of Public Health Boston, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Background:
There is inconsistent evidence regarding the influence of general cognitive abilities on the long-term course of depression.
Aims:
To investigate the association between general childhood cognitive abilities and adult depression outcomes.
Method:
We conducted a cohort study using data from 633 participants in the New England Family Study with lifetime depression. Cognitive abilities at age 7 were measured using the Wechsler Intelligence Scale for Children. Depression outcomes were assessed using structured diagnostic interviews administered up to four times in adulthood between ages 17 and 49.
Results:
In analyses adjusting for demographic factors and parental psychiatric illness, low general cognitive ability (i.e. IQ<85 v. IQ>115) was associated with recurrent depressive episodes (odds ratio (OR) = 2.19, 95% CI 1.20-4.00), longer episode duration (rate ratio 4.21, 95% CI 2.24-7.94), admission to hospital for depression (OR = 3.65, 95% CI 1.34-9.93) and suicide ideation (OR = 3.79, 95% CI 1.79-8.02) and attempt (OR = 4.94, 95% CI 1.67-14.55).
Conclusions:
Variation in cognitive abilities, predominantly within the normal range and established early in childhood, may confer long-term vulnerability for prolonged and severe depression. The mechanisms underlying this vulnerability need to be established to improve the prognosis of depression among individuals with lower cognitive abilities.
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