Abstract
Using prospective data on 3,170 respondents aged 18 years and over who were at risk for a first-onset major depression from the New Haven site of the Epidemiologic Catchment Area (ECA) study, these analyses assessed the effects of social status, physical health status, and social isolation on first-onset depression in a 1-year. period, controlling for demographic characteristics and baseline psychiatric factors. Among the assessed potential risk factors, poverty status [odds ratio (OR=2.034,P<0.05)] and confinement to a bed or chair (OR=4.015,P<0.05) were independently associated with an increased risk for a first-onset depressiveepisode when controlling for gender, age, past history of substance abuse, and subclinical depressive symptoms. The effects of poverly, and to a lesser degree homebound status, were substantially reduced when controlling for degree of isolation from friends and family, suggesting that social isolation mediates some of the relationships between social and physical statuses and major depression.
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References
American Psychiatric Association (1980) Diagnostic and statistical manual, 3rd edn. APA, Washington, DC
Aneshensel CS, Frerichs RR, Huba GS (1984) Depression and physical illness: a multiwave, nonrecursive model. J Health Soc Behav 25:350–371
Angermeyer MC, Klusman D (1987) From social class to social stress: new developments in psychiatric epidemiology. In: Angermeyer MC (ed) From social class to social stress. Springer, Berlin Heidelberg New York, pp 2–13
Anthony JC, Petronis KR (1991) Suspected risk factors for depression among adults 18–44 years old. Epidemiology 2:123–132
Berkman LF, Syme SL (1979) Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 109:186–204
Bromet EJ, Dunn LO, Connell MM (1986) Long term reliability of diagnosing lifetime major depression in a community sample. Arch Gen Psychiatry 43:435–440
Bruce ML, Leaf PJ (1989) Psychiatric disorders and 15 month mortality in a community sample of older adults. Am J Public Health 79:727–730
Bruce ML, McNamara R (1992) Psychiatric status among the home-bound elderly. J Am Geriatr Soc 40:561–566
Bruce ML, Takeuchi DT, Leaf PJ (1991) Poverty and psychiatric status. Arch Gen Psychiatry 48:470–474
Coryell W, Endicott J, Keller M (1992) Major depression in a nonclinical sample. Arch Gen Psychiatry 49:117–125
Coryell W, Scheftner W, Keller M, Endicott J, Maser J, Klerman GL (1993) The enduring psychosocial consequences of mania and depression. Am J Psychiatry 150:720–727
Dohrenwend BP (1990) Socioeconomic status (SES) and psychiatric disorders. Soc Psychiatry Epidemiol 25:41–47
Dohrenwend BP, Levav I, Shrout PE, Schwartz S, Naveh G, Link BG, Skodol AE, Stueve A (1992) Socioeconomic status and psychiatric disorders: the causation-selection issue. Science 255:946–952
Eaton WW, Kessler LG (eds) (1985) Epidemiologic methods in psychiatry: The NIMH Epidemiologic Catchment Area Program. Academic Press, New York
Eaton WW, Kramer M, Anthony JC, Dryman A, Shapiro S, Locke BZ (1989) The incidence of specific DIS/DSM-III mental disorders: data from the NIMH Epidemiologic Catchment Area Program. Acta Psychiatr Scand 79:163–178
Faris REL, Dunham W (1939) Mental disorders in urban areas. University of Chicago Press, Chicago
Gallo JJ, Royall DR, Anthony JC (1993) Risk factors for the onset of depression in middle age and later life. Soc Psychiatry Psychiatr Epidemiol 28:101–108
Greenley JR, Mullen JA (1990) Help seeking and the use of mental health services. Res Community Ment Health 6:325–350
Hirschfeld RMA, Cross CK (1982) Epidemiology of affective disorders Arch Gen Psychiatry 39:35–46
Hollingshead AB, Redlich FC (1958) Social class and mental illness: a community study. Wiley, New York
Holzer CE, Spitznagel E, Jordan KB, Timbers DM, Kessler LG, Anthony JC (1985) Sampling the household population. In: Eaton, WW, Kessler LG (eds) Epidemiologic field methods in psychiatry: the NIMH Epidemiologic Catchment Area Program. Academic Press, New York, pp 23–48
Kessler RC, Price RH, Wortman CB (1985) Social factors in psychopathology: stress, social support, and coping processes. Annu Rev Psychol 36:531–571
Kennedy GL, Klerman HR, Thomas C (1990) The emergence of depressive symptoms in late life: the importance of declining health and increasing disability. J Community Health 15:93–104
Kendler KS, Kessler RC, Neale MC, Heath AC, Eaves LJ (1993) The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry 150:1139–1148
Klerman GL, Weissman MM (1992) The course, morbidity, and costs of depression. Arch Gen Psychiatry 49:831–834
Leaf PJ, Bruce ML, Tischler GL, Freeman DH, Weissman MM, Myers JK (1988) Factors affecting the utilization of specialty and general medical mental health services. Med Care 26:9–26
Leaf PJ, Myers JK, McEvoy L (1991) Procedures used in the Epidemiologic Catchment Area studies. In: Robins L, Regier D (eds) Psychiatric disorders in America. Free Press, NY, pp 11–32
Leighton DC, Harding JS, Macklin DB, MacMillan AM, Leighton AH (1963) The character of danger: psychiatric symptoms in selected communities. Basic, New York
Mirowsky J, Ross C (1992) Age and depression. J Health Soc Behav 33:187–205
Murphy E (1982) Social origins of depression in old age. Br J Psychiatry 141:135–142
Murphy JM, Sobol AM, Olivier DC, Monson RR, Leighton AH, Pratt LA (1989) Prodromes of depression and anxiety: the Stirling County Study. Br J Psychiatry 155:490–495
Murphy J, Olivir DC, Monson RR, Sobol AM, Federman EB, Leighton AH (1991) Depression and anxiety in relation to social status. Arch Gen Psychiatry 48:223–229
Parker G (1987) Are the lifetime prevalence estimates in the ECA study accurate? Psychol Med 17:275–282
Research Triangle Institute (1992) Software for survey data analysis (SUDAAN 6.0). Research Triangle Park, NC
Robins LN, Helzer JE, Croughan J, Ratcliff KS (1981) National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 38:381–389
Robins LN, Orvaschel H, Anthony JC, Anthony JC, Blazer DG, Burnam A, Burke JD (1985) The Diagnostic Interview Schedule. In: Eaton WW, Kessler LG (eds) Epidemiologic methods in psychiatry: the NIMH Epidemiologic Catchment Area Program. Academic Press, New York, pp 143–170
Srole L, Langer TS, Michael ST, Opler MK, Rennie TAC (1962) Mental health in the metropolis: the Midtown Manhatten Study. McGraw-Hill, New York
Tepping BJ (1968) The estimation of variance in complex surveys. Proceedings of Social Statistical Section, Am Statis Ass, 11–18
Turner RJ, Noh S (1988) Physical disability and depression: a longitudinal analysis. J Health Soc Behav 29:23–37
Von Korff M, Ormel J, Katon J, Lin EHB (1992) Disability and depression among high utilizers of health care. Arch Gen Psychiatry 49:91–100
Weissman MM, Klerman GL (1977) Sex differences in the epidemiology of depression. Arch Gen Psychiatry 34:98–111
Weissman MM, Leaf PJ, Tischler GL, Blazer DG, Karno M, Bruce ML, Florio LP (1988) Affective disorders in five United States communities. Psychol Med 18:141–153
Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients. JAMA 262:914
Wells KB, Burnam MA, Rogers W, Hays R, Camp P (1992) The course of depression in adult outpatients. Arch Gen Psychiatry 49:788–794
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Bruce, M.L., Hoff, R.A. Social and physical health risk factors for first-onset major depressive disorder in a community sample. Soc Psychiatry Psychiatr Epidemiol 29, 165–171 (1994). https://doi.org/10.1007/BF00802013
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DOI: https://doi.org/10.1007/BF00802013