Depression and mortality in a longitudinal study: 1952-2011
- PMID: 29061855
- PMCID: PMC5654987
- DOI: 10.1503/cmaj.170125
Depression and mortality in a longitudinal study: 1952-2011
Abstract
Background: Many studies have shown that depression increases mortality risk. We aimed to investigate the duration of time over which depression is associated with increased risk of mortality, secular trends in the association between depression and mortality, and sex differences in the association between depression and mortality.
Methods: We conducted a cohort study of 3410 adults enrolled in 3 representative samples of a county in Atlantic Canada in 1952 (n = 1003), 1970 (n = 1203) or 1992 (n = 1402) (the Stirling County Study). Depression was measured using a diagnostic algorithm based on the presence of depressed mood and associated symptoms, duration of more than 1 month, and substantial impairment. Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database.
Results: Depression was associated with a heightened risk of mortality among men during the 3 time periods of the study, with hazard ratios (HRs) of 2.90 (95% confidence interval [CI] 1.69-4.98) between 1952 and 1967, 1.97 (CI 1.34-2.89) between 1968 and 1990, and 1.52 (CI 1.09-2.13) between 1991 and 2011. Elevated risk of mortality was noted among women only between 1990 and 2011 (HR = 1.51; CI = 1.11-2.05).
Interpretation: The association between depression and mortality persists over long periods of time and has emerged among women in recent decades, despite contemporaneous improvements in the treatment of depression and reduction of stigma associated with depression. Further research is needed to better understand the mechanisms involved.
© 2017 Canadian Medical Association or its licensors.
Conflict of interest statement
Competing interests: Ian Colman, Jane Murphy and Mila Kingsbury report grants from the Canadian Institutes of Health Research, during the conduct of the study. Jane Murphy reports a grant from the National Institute of Mental Health, during the conduct of the study. No other competing interests were declared.
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