Background: Numerous general community studies have been published in the last decade examining the excess mortality associated with depression. Little is known regarding the association existing in younger populations.
Methods: The first aim of the dissertation involved a systematic review of observational cohort studies from general community populations. Two independent reviewers assessed articles for potential inclusion; 148 articles were assessed for full-text. A total of 95 articles were included in the review and 57 articles were included in the meta-analysis.
Aims two and three involved the revival of cross-sectional epidemiologic study, the Community Mental Health Epidemiology Program, which enrolled 2,762 participants between 1971-1974 in Washington County, Maryland. Baseline measurement of depressed mood was linked with a 40-year assessment of death records. All cause of death information came from the underlying cause of death listed on the death certificate.
Results: A moderate, positive pooled risk estimate was calculated for the association between depression and mortality in the general community: 1.64 (1.49-1.80), p <0.001). The observed association appears influenced by selection biases, participant age range, length of follow-up, and background study death rate.
There was a sustained, significant association across the total 40-year follow-up period (hazard ratio: 1.29 (1.12-1.49)) after adjustment for age, sex, education level, smoking history, and healthy body mass index. Significant interactions with sex, age, and follow-up time period were present. The strongest associations between depressed mood and mortality occurred for young adults and males.
The relative subdistribution hazards for cardiovascular deaths (3.08 (1.74-5.45)) and fatal injuries (4.63 (1.76-12.18)) were significant over the entire 40-year period for young adults (18-39 years old at baseline). There were no significant associations between depressed mood and cancer deaths for any age group.
Conclusions: An association exists between depression and mortality in the general community. The results of this study indicate that the association persists over extended periods of time. The findings emphasize the toll depressed mood may be taking on the life span of young adults.
|School:||The Johns Hopkins University|
|School Location:||United States -- Maryland|
|Source:||DAI-B 73/12(E), Dissertation Abstracts International|
|Subjects:||Mental health, Epidemiology|
|Keywords:||Depression, Depressive symptoms, Mental health epidemiology, Mortality|
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