Andre R Brunoni1, Itamar S Santos2, Ives C Passos3, Alessandra C Goulart4, Ai Koyanagi5, Andre F Carvalho6, Sandhi M Barreto7, Maria Carmen Viana8, Paulo A Lotufo2, Isabela M Benseñor2. 1. Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (HU-USP), Av. Prof Lineu Prestes 2565, Butantã, CEP 05508-000 São Paulo, Brazil. Electronic address: brunoni@usp.br. 2. Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (HU-USP), Av. Prof Lineu Prestes 2565, Butantã, CEP 05508-000 São Paulo, Brazil. 3. Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 4. Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (HU-USP), Av. Prof Lineu Prestes 2565, Butantã, CEP 05508-000 São Paulo, Brazil. 5. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain. 6. Department of Psychiatry, Faculty of Medicine, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada. 7. School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Brazil. 8. Departamento de Medicina Social, Universidade Federal do Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
Abstract
BACKGROUND: Depression is a main source of disability worldwide. Identifying risk factors associated with incident and persistent episodes could inform clinical practice and hence mitigate their burden. However, previous research has focused on populations from developed countries. Thus, we evaluated sociodemographic risk factors and psychiatric comorbidities associated with incident and persistent depression in a large Brazilian occupational cohort. METHODS: We examined baseline (2008-2010, n = 15,105) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Based on the presence of depression diagnosis at two timepoints, we diagnosed persistent and incident depression. Simple and multiple logistic regression analyses were employed to explore risk factors associated with incident and persistent depression. As gender is associated with the exposure and outcome variables, analyses stratified by gender were also conducted. RESULTS: Presence of any anxiety disorder, obsessive-compulsive disorder, and female gender were significant (p < 0.001) risk factors for depression incidence (odds ratios of 2.59, 3.6, and 1.82, respectively) and persistence (odds ratios of 6.94, 14.37, and 2.85, respectively) in multiple models, whereas having university degree decreased the odds of depression incidence (0.74) and persistence (0.45). In stratified analyses, the effects of low education were only evident in women. LIMITATIONS: Brief depressive episodes could not be measured by our assessments. CONCLUSION: In this occupational cohort, female gender, low education and psychiatric comorbidities were associated with unfavorable depression courses. Interventions targeting comorbidities could prevent depression incidence and persistence.
BACKGROUND:Depression is a main source of disability worldwide. Identifying risk factors associated with incident and persistent episodes could inform clinical practice and hence mitigate their burden. However, previous research has focused on populations from developed countries. Thus, we evaluated sociodemographic risk factors and psychiatric comorbidities associated with incident and persistent depression in a large Brazilian occupational cohort. METHODS: We examined baseline (2008-2010, n = 15,105) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Based on the presence of depression diagnosis at two timepoints, we diagnosed persistent and incident depression. Simple and multiple logistic regression analyses were employed to explore risk factors associated with incident and persistent depression. As gender is associated with the exposure and outcome variables, analyses stratified by gender were also conducted. RESULTS: Presence of any anxiety disorder, obsessive-compulsive disorder, and female gender were significant (p < 0.001) risk factors for depression incidence (odds ratios of 2.59, 3.6, and 1.82, respectively) and persistence (odds ratios of 6.94, 14.37, and 2.85, respectively) in multiple models, whereas having university degree decreased the odds of depression incidence (0.74) and persistence (0.45). In stratified analyses, the effects of low education were only evident in women. LIMITATIONS: Brief depressive episodes could not be measured by our assessments. CONCLUSION: In this occupational cohort, female gender, low education and psychiatric comorbidities were associated with unfavorable depression courses. Interventions targeting comorbidities could prevent depression incidence and persistence.
Authors: Daniel Fatori; Paulo Suen; Pedro Bacchi; Leonardo Afonso; Izio Klein; Beatriz A Cavendish; Younga H Lee; Zhaowen Liu; Joshua Bauermeister; Marina L Moreno; Maria Carmen Viana; Alessandra C Goulart; Itamar S Santos; Sarah Bauermeister; Jordan Smoller; Paulo Lotufo; Isabela M Benseñor; André R Brunoni Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2022-09-17 Impact factor: 4.519
Authors: K S Vidal; C K Suemoto; A B Moreno; B Duncan; M I Schmidt; M Maestri; S M Barreto; P A Lotufo; L Bertola; I M Bensenor; A R Brunoni Journal: Braz J Med Biol Res Date: 2020-10-30 Impact factor: 2.590