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Depression and mortality in a longitudinal study: 1952-2011.

Stephen E Gilman1, Ewa Sucha2, Mila Kingsbury2

  • 1Health Behavior Branch, Division of Intramural Population Health Research (Gilman), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md.; Department of Mental Health (Gilman), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Department of Mathematics and Statistics (Sucha), and School of Epidemiology and Public Health (Sucha, Kingsbury), University of Ottawa, Ottawa, Ont.; Department of Mathematics and Statistics (Horton), Amherst College, Amherst, Mass.; Department of Psychiatry (Murphy), Massachusetts General Hospital and Harvard Medical School; Department of Epidemiology (Murphy), Harvard TH Chan School of Public Health, Boston, Mass.; Department of Psychiatry (Murphy), Dalhousie University Faculty of Medicine, Halifax, NS; School of Epidemiology, Public Health & Preventive Medicine (Colman), University of Ottawa, Ottawa, Ont. stephen.gilman@nih.gov.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
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Summary

Depression consistently increases mortality risk over time, particularly for men. This association has recently emerged for women, despite advancements in depression treatment and reduced stigma.

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Area of Science:

  • Psychiatry
  • Epidemiology
  • Public Health

Background:

  • Numerous studies link depression to increased mortality risk.
  • The temporal relationship, secular trends, and sex differences in this association require further investigation.

Purpose of the Study:

  • To examine the duration of the depression-mortality association.
  • To investigate secular trends in this association.
  • To explore sex differences in the depression-mortality link.

Main Methods:

  • A cohort study of 3410 adults from Stirling County, Canada, with samples from 1952, 1970, and 1992.
  • Depression assessed via diagnostic algorithm (depressed mood, symptoms, duration >1 month, impairment).
  • Mortality data obtained through 2011 via Canadian Mortality Database linkage.

Main Results:

  • Depression elevated mortality risk in men across all study periods (1952-2011).
  • Hazard ratios for men ranged from 1.52 to 2.90.
  • Elevated mortality risk in women emerged only between 1990-2011 (HR=1.51).

Conclusions:

  • The depression-mortality association is persistent over long durations.
  • This association has become evident in women in recent decades.
  • Further research is necessary to elucidate the underlying mechanisms.