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Depression increases risk for death in men, women

The association between depression and increased risk for mortality was observed among men since 1952, but only found among women from 1991 to 2011.

“The duration of time over which depression increases mortality risk can provide insight into underlying mechanisms. Mortality risk over relatively short periods of time could be attributed to unnatural causes of death, including suicide and unintentional injuries — which are demonstrably elevated among individuals with depression,” Stephen E. Gilman, ScD, of Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues wrote. “In contrast, mortality risk over longer periods of time may be more likely to result from chronic conditions associated with depression. The question of duration is also important, from a clinical perspective: a history of depression is a strong predictor of later recurrence, and according to long-term follow-up studies, as many as one-third of individuals with depression will have a chronic form of the disorder.”

To determine the duration of time over which depression is associated with increased mortality risk and trends in the association between depression and mortality, researchers analyzed data for 3,410 adults enrolled in three representative samples of a county in Atlantic Canada in 1952 (n = 1,003), 1970 (n = 1,203) or 1992 (n = 1,402).

Depression was associated with increased risk for mortality among men between 1952 and 1967 (HR = 2.9; 95% CI, 1.69-4.98), 1968 and 1990 (HR = 1.97; 95% CI, 1.34-2.89), and 1991 and 2011 (HR = 1.52; 95% CI, 1.09-2.13).

Depression was associated with increased risk for mortality among women only between 1990 and 2011 (HR = 1.51; 95% CI, 1.11-2.05).

“The association between depression and mortality persists over long periods of time,” the researchers wrote. “The association was strongest for current depression, which tended to weaken within an individual over time unless there was a recurrent episode. The important implication of this finding, which needs to be pursued further, is whether remission from depression (either spontaneously or due to treatment) can reverse the elevated risk of mortality otherwise associated with depression.” – by Amanda Oldt

Disclosures: Gilman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.