Browsing by Subject "depressive disorder"

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    Cardiovascular Risk Factors as Differential Predictors of Incident Atypical and Typical Major Depressive Disorder in U.S. Adults
    (Wolters Kluwer, 2018-03) Patel, Jay S.; Bernston, Jessica; Polanka, Brittanny M.; Stewart, Jesse C.; Psychology, School of Science
    Objectives While the association between major depressive disorder (MDD) and future cardiovascular disease (CVD) is established, less is known about the relationship between CVD risk factors and future depression, and no studies have examined MDD subtypes. Our objective was to determine whether hypertension, tobacco use, and body mass index (BMI) differentially predict atypical and typical MDD in a national sample of U.S. adults. Methods We examined prospective data from 22,915 adults with no depressive disorder history at baseline who participated in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). CVD risk factors (Wave 1) and incident MDD subtypes (Wave 2) were determined by structured interviews. Results There were 252 atypical and 991 typical MDD cases. In fully-adjusted models, baseline hypertension (OR=0.58, 95% CI: 0.43-0.76), former tobacco use (OR=1.46, 95% CI: 1.20-1.78), and BMI (OR=1.32, 95% CI: 1.25-1.40; all p’s<0.001) predicted incident atypical MDD versus no MDD, whereas no CVD risk factor predicted incident typical MDD. Baseline hypertension (OR=0.52, 95% CI: 0.39-0.70), former tobacco use (OR=1.53, 95% CI: 1.22-1.93), and BMI (OR=1.26, 95% CI: 1.18-1.36; all p’s<0.001) also predicted incident atypical MDD versus typical MDD. Conclusions Our study is the first to report that CVD risk factors differentially predict MDD subtypes, with hypertension (protective factor), former tobacco use (risk factor), and BMI (risk factor) being stronger predictors of incident atypical versus typical MDD. Such evidence could provide insights into the etiologies of MDD subtypes and inform interventions tailored to MDD subtype.
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    Number of Recent Stressful Life Events and Incident Cardiovascular Disease: Moderation by Lifetime Depressive Disorder
    (Elsevier, 2017) Berntson, Jessica; Patel, Jay S.; Stewart, Jesse C.; Department of Psychology, School of Science
    Objective We investigated whether number of recent stressful life events is associated with incident cardiovascular disease (CVD) and whether this relationship is stronger in adults with a history of clinical depression. Methods Prospective data from 28,583 U.S. adults (mean age = 45 years) initially free of CVD who participated in Waves 1 (2001–2002) and 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Number of past-year stressful life events (Wave 1), lifetime depressive disorder (Wave 1), and incident CVD (Wave 2) were determined by structured interviews. Results There were 1069 cases of incident CVD. Each additional stressful life event was associated with a 15% increased odds of incident CVD [Odds Ratio (OR) = 1.15, 95% Confidence Interval (CI): 1.11, 1.19]. As hypothesized, a stressful life events by lifetime depressive disorder interaction was detected (P = 0.003). Stratified analyses indicated that stressful life events had a stronger association with incident CVD among adults with (OR = 1.18, 95% CI: 1.10, 1.27, n = 4908) versus without (OR = 1.10, 95% CI: 1.07, 1.14, n = 23,675) a lifetime depressive disorder. Conclusion Our findings suggest that a greater number of recent stressful life events elevate the risk of new-onset CVD and that this risk is potentiated in adults with a history of clinical depression.