Summary
Using prospectively gathered data to study first-time occurrence of major depression rather than its persistence, this inquiry tested whether the risk of major depression might be elevated among middle-aged and older adults who were not currently working for pay and among those with less than 12 years of schooling. Diagnostic interviews were administered 1 year apart to identify incident cases of major depression among 7,737 continuing participants of the Epidemiologic Catchment Area Program aged 40 years and older. After all subjects were sorted into risk sets by age and residence census tract, and after persons with a prior history of major depression were excluded, in 162 risk sets, there were 180 incident cases as well as 960 subjects at risk for future occurrence of major depression. The estimated risk for persons not currently working for pay was not reliably greater than the level of risk for those currently working for pay [estimated relative risk (RR)=1.48; 95% confidence interval (CI), 0.85–2.56]. Compared with adults who had 12 or more years of schooling, those who had less schooling were at increased risk (RR=2.22; 95% CI, 1.42–3.46). Compared to men with more than 12 years of schooling, women with less schooling were at especially increased risk for major depression over the course of the 1-year follow-up interval (RR=3.26; 95% CI, 1.78–5.95).
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References
American Psychiatric Association, Committee on Nomenclature and Statistics (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC
Anthony JC, Petronis KR (1991) Epidemiologic study of suspected risk factors for depression among adults 18–44 years old. Epidemiology 2: 123–132
Anthony JC, Tien AY, Petronis KR (1989) Epidemiologic evidence on cocaine use and panic attacks. Am J Epidemiol 129: 543–549
Anthony JC, Folstein M, Romanoski AJ, Von Korff MR, Nestadt GR, Chahal R, Merchant A, Brown CH, Shapiro S, Kramer M, Gruenberg EM (1985) Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: experience in Eastern Baltimore. Arch Gen Psychiatry 42: 667–675
Blazer D, Swartz M, Woodbury M, Manton KG, Hughes D, George LK (1988) Depressive symptoms and depressive diagnoses in a community population: use of a new procedure for analysis of psychiatric classification. Arch Gen Psychiatry 45: 1078–1084
Bruce ML, Leaf PJ, Rozal GPM, Florio L Psychiatric status and 9-year mortality in the New Haven Epidemiologic Catchment Area Study. Under review
Carpiniello B, Carta MG, Rudas N (1989) Depression among elderly people. Acta Psychiatr Scand 80: 445–450
Crum RM, Bucholz KK, Helzer JE, Anthony JC (1992) The risk of alcohol abuse and dependence in adulthood: the association with educational level. Am J Epidemiol 135: 989–999
Dohrenwend BP, Levav I, Shrout PE, Schwartz S, Naveh G, Link BG, Skokdol AE, Stueve A (1992) Socioeconomic status and psychiatric disorders: the causation-selection issue. Science 255: 946–952
Eaton WW, Anthony JC, Tepper S, Dryman A (1992) Psychopathology and attrition in the Epidemiologic Catchment Area surveys. Am J Epidemiol 135: 1051–1059
Eaton W, 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
Eaton WW, Kessler LG (eds) (1985) Epidemiologic field methods in psychiatry: the NIMH Epidemiologic Catchment Area Program. Academic Press, Orlando, Florida
Eaton WW, Holzer CE, Von Korff M, Anthony JC, Helzer JE, George L, Burnam MA, Boyd JH, Kessler LG, Locke BZ (1984) The design of the Epidemiologic Catchment Area Surveys: the control and measurement of error. Arch Gen Psychiatry 41: 942–948
Harlow SD, Goldberg EL, Comstock GW (1991) A longitudinal study of risk factors for depressive symptomatology in elderly widowed and married women. Am J Epidemiol 134: 526–538
Hosmer DW, Lemeshow S (1989) Applied logistic regression. Wiley, New York
Kennedy GJ, Kelman HR, Thomas C, Wisniewski W, Metz H, Bijur PE (1989) Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry 146: 220–225
Kleinbaum DG, Kupper LL, Morgenstern H (1982) Epidemiologic research: principles and quantitative methods. Lifetime Learning Publications, Belmont, California p 379
Lillie-Blanton M, Anthony JC, Schuster CR (1993) Probing the meaning of racial/ethnic group comparisons in crack cocaine smoking. JAMA 269: 992–997
Parker G (1987) Are the lifetime prevalence estimates in the ECA study accurate? Psychol Med 17: 275–282
Petronis KR, Samuels JF, Moscicki EK, Anthony JC (1990) An epidemiologic investigation of potential risk factors for suicide attempts. Soc Psychiatry Psychiatr Epidemiol 25: 193–199
Petronis KR, Anthony JC (1989) An epidemiologic investigation of marijuana and cocaine related palpitations. Drug Alcohol Depend 23:219–226
Phifer JF, Murrell SA (1986) Etiologic factors in the onset of depressive symptoms in older adults. J Abnorm Psychol 95: 282–291
Robins LN, Helzer JE, Weissman MM, Orvaschel H, Greenberg E, Burke JD, Regier DA (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 41: 949–958
Rogler LH, Malgady RG, Tryon WW (1992) Evaluation of mental health: issues of memory in the Diagnostic Interview Schedule. J Nerv Ment Dis 180: 215–222
Sackett DL (1979) Bias in analytic research. J Chronic Dis 32: 51–68
Schlesselman JJ (1982) Case-control studies: design, conduct, analysis. Oxford University Press, New York, pp 113–114
Tien AY, Anthony JC (1990) Epidemiological analysis of alcohol and drug use as risk factors for psychotic experiences. J Nerv Ment Dis 178: 473–480
Tweed DL, Blazer DG, Ciarlo JA (1992) Psychiatric epidemiology in elderly populations. In: Wallace RB, Woolson RF (eds) The epidemiologic study of the elderly. Oxford University Press, New York, pp 213–233
Vazquez-Barquero JL, Manrique JFD, Munoz J, Arango JM, Gaite L, Herrera S, Der GJ (1992) Sex differences in mental illiness: a community study of the influence of physical health and sociodemographic factors. Soc Psychiatry Psychiatr Epidemiol 27: 62–68
Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C (1991) Affective disorders. In: Robins LN, Regier DA (eds) Psychiatric disorders in America: the Epidemiologic Catchment Area Study. Free Press, New York, pp 53–80
Weissman MM, Leaf PJ, Bruce ML, Florio L (1988) The epidemiology of dysthymia in five communities: rates, risks, co-morbidity, and treatment. Am J Psychiatry 145: 815–819
Wickramaratne PJ, Weissman MM, Leaf PJ, Holford TR (1989) Age, period and cohort effects and the risk of major depression: results from five United States communities. J Clin Epidemiol 42: 333–343
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Gallo, J.J., Royall, D.R. & Anthony, J.C. Risk factors for the onset of depression in middle age and later life. Soc Psychiatry Psychiatr Epidemiol 28, 101–108 (1993). https://doi.org/10.1007/BF00801739
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DOI: https://doi.org/10.1007/BF00801739