Health and Social Factors Predict Changes in Depressive Symptoms in Women
Socioeconomic disadvantage and abusive experiences predicted slower reductions in depressive symptoms over time.
Among young women, many health and social factors, including education and financial status, access to social support systems, and lifestyle behaviors, are associated with fluctuations in depressive symptoms over time, according to a study published in the Journal of Affective Disorders.
The investigators of this study sought to identify mental health and demographic variables among young women that predict positive or negative changes in depressive symptoms and determine whether early intervention could help detect or even prevent major depression in this population.
The study sample included 7663 women aged 22 to 27 years from the Australian Longitudinal Study on Women's Health who reported at least 1 indicator of poor mental health during the 12-year study period. Self-reported depressive symptoms were collected over 5 waves of survey data, which were measured at 3-year intervals between 2000 and 2012.
Investigators performed a secondary analysis of variables already associated with major depression, including education and income, adverse life events (childhood sexual abuse and partner violence), health-related behaviors (diet and physical activity), substance use (alcohol, tobacco, and other drugs), and motherhood.
Using linear mixed models, the investigators identified factors associated with change in depressive symptom scores between successive surveys, or study waves.
Results showed that depressive symptoms decreased slightly among the overall sample. Adjusting for variables, a greater reduction of depressive symptoms over time was associated with women who reported greater initial symptoms, had more social support, and self-reported higher general health. Lower educational attainment and difficulty managing on their income was associated with smaller reductions in depressive symptoms over time. Similarly, high or no alcohol consumption, high stress, low social support, and history of childhood sexual assault or partner violence also predicted smaller reductions.
Motherhood was the only factor that showed a significant interaction with survey number, or study wave; motherhood predicted an increase in depressive symptoms at Survey 2 but a decrease in depressive symptoms at Survey 5. This suggests that there is possibly more support for mothers at a normative age than at earlier ages.
Lack of exercise, tobacco use, and recreational drug use were not predictive of change in depressive symptoms.
Limitations to the study included the fact that the original study focused on a range of issues and was not designed specifically to measure mental health and the potential bias of self-reported data. The 3-year intervals limited the opportunity to capture all the fluctuating factors in young women's lives. Finally, the investigators note that the national sample had a slight bias toward Australian-born women with higher educational attainment.
A range of sociodemographic and health factors may be used to predict changes in depressive symptoms among young women over time. The investigators suggest that several interventions, including improved access to education and financial resources, promotion of positive social support systems, and adoption of healthy lifestyle changes, can help prevent at-risk women from developing clinical conditions.
Holden L, Harris M, Hockey R, et al. Predictors of change in depressive symptoms over time: results from the Australian Longitudinal Study on Women's Health [published online November 12, 2018]. J Affect Disorders. doi:10.1016/j.jad.2018.11.076