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Social Psychiatry and Psychiatric Epidemiology

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01-01-2021 | Affective Disorder | Original Paper

Age-varying associations between lifestyle risk factors and major depressive disorder: a nationally representative cross-sectional study of adolescents

Authors: Matthew Sunderland, Katrina Champion, Tim Slade, Cath Chapman, Nicola Newton, Louise Thornton, Frances Kay-Lambkin, Nyanda McBride, Steve Allsop, Belinda Parmenter, Maree Teesson, Health4Life Team

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2021

Abstract

Purpose

Lifestyle risk factors, such as alcohol use, smoking, high body mass index, poor sleep, and sedentary behavior, represent major public health issues for adolescents. These factors have been associated with increased rates of major depressive disorder (MDD). The purpose of this paper is to investigate critical peaks in the prevalence of MDD at certain ages and to examine how these peaks might be amplified or attenuated by the presence of lifestyle risk factors.

Methods

A nationally representative sample of adolescents aged 11–17 years old (n = 2967) and time-varying effect models were used to investigate the associations between lifestyle risk factors and the prevalence of MDD by sex.

Results

The estimated prevalence of MDD significantly increased among adolescents from 4% (95% CI 3–6%) at 13 years of age to 19% (95% CI 15–24%) at 16 years of age. From the age of 13, males were significantly less likely to have a diagnosis of MDD than females with the maximum sex difference occurring at the age of 15 (OR 0.24, 95% CI 0.13–0.47). All lifestyle risk factors were at some point significantly associated with MDD, but these associations did not differ by sex, except for body mass index.

Discussion

These findings suggest that interventions designed to prevent the development of depression should be implemented in early adolescence, ideally before or at the age of 13 and particularly among young females given that the prevalence of MDD begins to rise and diverge from young males. Interventions should also simultaneously address lifestyle risk factors and symptoms of major depression.

Available only for authorised users

Body mass index was used in the current study as a proxy measure for low physical activity and poor diet given the well-established correlation between poor physical activity, poor diet, and high BMI.

Preliminary analysis examined the fit on linear versus non-linear models for the age-varying relationship between all covariates and MDD. On all occasions, the non-linear models provided superior fit based on AIC and BIC values and therefore justified the use of TVEMs in this study. The results are provided in Supplementary Table 1.

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Title: Age-varying associations between lifestyle risk factors and major depressive disorder: a nationally representative cross-sectional study of adolescents
Authors: Matthew Sunderland
Katrina Champion
Tim Slade
Cath Chapman
Nicola Newton
Louise Thornton
Frances Kay-Lambkin
Nyanda McBride
Steve Allsop
Belinda Parmenter
Maree Teesson
Health4Life Team
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Affective Disorder
Affective Disorder
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 1/2021
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-020-01888-8

At a glance: The STEP trials

Springer Medicine

Age-varying associations between lifestyle risk factors and major depressive disorder: a nationally representative cross-sectional study of adolescents

Abstract

Purpose

Methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Discussion

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