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Comparison of risk factors for the onset and maintenance of depression
- Authors:
- BOTTOMLEY Christian, et al
- Journal article citation:
- British Journal of Psychiatry, 196(1), January 2010, pp.13-17.
- Publisher:
- Cambridge University Press
Factors associated with depression are usually identified from cross-sectional studies. This article explores the relative roles of onset and recovery in determining these associations. Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months. Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor’s effect on onset is highly predictive of its impact on recovery. Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.