Skip to main content
×
Home
    • Aa
    • Aa

Patterns of association of chronic medical conditions and major depression

  • S. B. Patten (a1), J. V. A. Williams (a2), D. H. Lavorato (a2), J. L. Wang (a3), N. Jetté (a4), T. T. Sajobi (a4), K. M. Fiest (a5) and A. G. M. Bulloch (a3)...
Abstract
Aims.

Age and sex-related patterns of association between medical conditions and major depressive episodes (MDE) are important for understanding disease burden, anticipating clinical needs and for formulating etiological hypotheses. General population estimates are especially valuable because they are not distorted by help-seeking behaviours. However, even large population surveys often deliver inadequate precision to adequately describe such patterns. In this study, data from a set of national surveys were pooled to increase precision, supporting more precise characterisation of these associations.

Methods.

The data were from a series of Canadian national surveys. These surveys used comparable sampling strategies and assessment methods for MDE. Chronic medical conditions were assessed using items asking about professionally diagnosed medical conditions. Individual-level meta-analysis methods were used to generate unadjusted, stratified and adjusted prevalence odds ratios for 11 chronic medical conditions. Random effects models were used in the meta-analysis. A procedure incorporating rescaled replicate bootstrap weights was used to produce 95% confidence intervals.

Results.

Overall, conditions characterised by pain and inflammation tended to show stronger associations with MDE. The meta-analysis uncovered two previously undescribed patterns of association. Effect modification by age was observed in varying degrees for most conditions. This effect was most prominent for high blood pressure and cancer. Stronger associations were found in younger age categories. Migraine was an exception: the strength of association increased with age, especially in men. Second, especially for conditions predominantly affecting older age groups (arthritis, diabetes, back pain, cataracts, effects of stroke and heart disease) confounding by age was evident. For each condition, age adjustment resulted in strengthening of the associations. In addition to migraine, two conditions displayed distinctive patterns of association. Age adjusted odds ratios for thyroid disease reflected a weak association that was only significant in women. In epilepsy, a similar strength of association was found irrespective of age or sex.

Conclusions.

The prevalence of MDE is elevated in association with most chronic conditions, but especially those characterised by inflammation and pain. Effect modification by age may reflect greater challenges or difficulties encountered by young people attempting to cope with these conditions. This pattern, however, does not apply to migraine or epilepsy. Neurobiological changes associated with these conditions may offset coping-related effects, such that the association does not weaken with age. Prominent confounding by age for several conditions suggests that age adjustments are necessary in order to avoid underestimating the strength of these associations.

Copyright
Corresponding author
*Address for correspondence: S. B. Patten, Department of Community Health Sciences and Department of Psychiatry, Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4Z6, Canada. (Email: patten@ucalgary.ca)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

CM Aldwin , KJ Sutton , G Chiara , A Piro (1996). Age differences in stress, coping, and appraisal: findings from the normative aging study. Journal of Gerontology 51B, 179188.

F Antonaci , G Nappi , F Galli , GC Manzoni , P Calabresi , A Costa (2011). Migraine and psychiatric comorbidity: a review of clinical findings. Journal of Headache and Pain 12, 115125.

JM Pavlovic , WF Stewart , CA Bruce , JA Gorman , H Sun , DC Buse , RB Lipton (2015). Burden of migraine related to menses: results from the AMPP study. Journal of Headache and Pain 16, 24.

WF Pirl , J Greer , JS Temel , BY Yeap , SE Gilman (2009). Major depressive disorder in long-term cancer survivors: analysis of the National Comorbidity Survey Replication. Journal of Clinical Oncology 27, 41304134.

F Radat , J Swendsen (2005). Psychiatric comorbidity in migraine: a review. Cephalalgia 25, 165178.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology and Psychiatric Sciences
  • ISSN: 2045-7960
  • EISSN: 2045-7979
  • URL: /core/journals/epidemiology-and-psychiatric-sciences
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 11
Total number of PDF views: 107 *
Loading metrics...

Abstract views

Total abstract views: 539 *
Loading metrics...

* Views captured on Cambridge Core between 27th October 2016 - 24th July 2017. This data will be updated every 24 hours.