Clinical and course characteristics of depression and all-cause mortality: A prospective population-based study

• Published in: Journal of affective disorders Vol. 189; pp. 17 - 24
• Main Authors: Lasserre, Aurélie M, Marti-Soler, Helena, Strippoli, Marie-Pierre F, Vaucher, Julien, Glaus, Jennifer, Vandeleur, Caroline L, Castelao, Enrique, Marques-Vidal, Pedro, Waeber, Gérard, Vollenweider, Peter, Preisig, Martin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2016
• Subjects: Adult; Aged; All-cause mortality; Cardiovascular Diseases - mortality; Cardiovascular risk factors; Cohort Studies; Current depression; Depression - mortality; Depressive Disorder - mortality; Depressive disorders; Female; Humans; Lifestyle; Male; Mental Health - statistics & numerical data; Middle Aged; Population-based study; Proportional Hazards Models; Prospective Studies; Psychiatry; Remission; Risk Factors; Switzerland - epidemiology; Switzerland; All-cause mortality; Cardiovascular risk factors; Current depression; Population-based study; Remission; Lifestyle; Depressive disorders
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2015.09.010

Abstract Background Given the large heterogeneity of depressive disorders (DD), studying depression characteristics according to clinical manifestations and course is a more promising approach than studying depression as a whole. The purpose of this study was to determine the association between clinical and course characteristics of DD and incident all-cause mortality. Methods CoLaus|PsyCoLaus is a prospective cohort study (mean follow-up duration=5.2 years) including 35–66 year-old randomly selected residents of an urban area in Switzerland. A total of 3668 subjects (mean age 50.9 years, 53.0% women) underwent physical and psychiatric baseline evaluations and had a known vital status at follow-up (98.8% of the baseline sample). Clinical (diagnostic severity, atypical features) and course characteristics (recency, recurrence, duration, onset) of DD according to the DSM-5 were elicited using a semi-structured interview. Results Compared to participants who had never experienced DD, participants with current but not remitted DD were more than three times as likely to die (Hazard Ratio: 3.2, 95% CI: 1.1–10.0) after adjustment for socio-demographic and lifestyle characteristics, comorbid anxiety disorders, antidepressant use, and cardiovascular risk factors and diseases. There was no evidence for associations between other depression characteristics and all-cause mortality. Limitations The small proportion of deceased subjects impeded statistical analyses of cause-specific mortality. Conclusions A current but not remitted DD is a strong predictor of all-cause mortality, independently of cardiovascular or lifestyle factors, which suggests that the effect of depression on mortality diminishes after remission and further emphasizes the need to adequately treat current depressive episodes.