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J Affect Disord. 2016 Jan 1;189:17-24. doi: 10.1016/j.jad.2015.09.010. Epub 2015 Sep 14.

Clinical and course characteristics of depression and all-cause mortality: A prospective population-based study.

Author information

1
Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, 1008 Prilly, Switzerland. Electronic address: aurelie.lasserre@chuv.ch.
2
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
3
Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, 1008 Prilly, Switzerland.
4
Department of Internal Medicine, Lausanne University Hospital, 1011 Lausanne, Switzerland.

Abstract

BACKGROUND:

Given the large heterogeneity of depressive disorders (DD), studying depression characteristics according to clinical manifestations and course is a more promising approach than studying depression as a whole. The purpose of this study was to determine the association between clinical and course characteristics of DD and incident all-cause mortality.

METHODS:

CoLaus|PsyCoLaus is a prospective cohort study (mean follow-up duration=5.2 years) including 35-66 year-old randomly selected residents of an urban area in Switzerland. A total of 3668 subjects (mean age 50.9 years, 53.0% women) underwent physical and psychiatric baseline evaluations and had a known vital status at follow-up (98.8% of the baseline sample). Clinical (diagnostic severity, atypical features) and course characteristics (recency, recurrence, duration, onset) of DD according to the DSM-5 were elicited using a semi-structured interview.

RESULTS:

Compared to participants who had never experienced DD, participants with current but not remitted DD were more than three times as likely to die (Hazard Ratio: 3.2, 95% CI: 1.1-10.0) after adjustment for socio-demographic and lifestyle characteristics, comorbid anxiety disorders, antidepressant use, and cardiovascular risk factors and diseases. There was no evidence for associations between other depression characteristics and all-cause mortality.

LIMITATIONS:

The small proportion of deceased subjects impeded statistical analyses of cause-specific mortality.

CONCLUSIONS:

A current but not remitted DD is a strong predictor of all-cause mortality, independently of cardiovascular or lifestyle factors, which suggests that the effect of depression on mortality diminishes after remission and further emphasizes the need to adequately treat current depressive episodes.

KEYWORDS:

All-cause mortality; Cardiovascular risk factors; Current depression; Depressive disorders; Lifestyle; Population-based study; Remission

PMID:
26402343
DOI:
10.1016/j.jad.2015.09.010
[Indexed for MEDLINE]

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