Estimating the associations between personal, health, lifestyle, and social factors on depressive symptoms from...

Numerous studies have tried to understand the causes of mental health problems, mostly focusing on single exposures. These approaches often fail to capture the complex and interconnected nature of mental health problems. This study aims to investigate the associations of concurrent age-specific changes in explanatory factors, encompassing personal, health, lifestyle, and social factors and depressive symptoms in individuals aged 15 to 32 years. Individuals born in 1989 were followed from 2004 to 2021 with surveys at ages 15, 18, 21, 28, and 32. Inverse probability weights and multiple imputations with chained equations were used to account for attrition and missing data. Descriptive characteristics for each wave were estimated as well as the changes in depressive symptoms and explanatory variables between each wave. Fixed effect regression models and dominance analyses examined the contribution of change in each explanatory variable to the change in depressive symptoms between each wave. Lastly, analyses of asymmetric change were estimated to detect asymmetric associations of explanatory variables and depressive symptoms. The relative importance of the explanatory variables changed between age points. Between all age points, stress was the most dominant variable with a relative contribution above 30% between all age points, while the contribution of sense of coherence increased through the waves from 17% to 25%. Self-esteem, self-rated health, and psychosomatic symptoms had also high dominance with shifting contributions through the ages. The associations between explanatory factors and depressive symptoms are dynamic and preventive strategies should be tailored towards the different life stages.