Adverse childhood experiences, stressful life events or demographic factors: which are important in women's depression? A 2-year follow-up population study.
OBJECTIVE
The aim of this study was to simultaneously test adverse background factors, namely adverse childhood experiences (ACEs), stressful life events and prior depressive symptoms, for their ability to predict recovery and non-recovery from depression in women among the general population.


METHODS
A stratified random sample of women (n = 835) from the general population was collected at baseline in 1999. Depression (Beck Depression Inventory, BDI-21), ACEs and background factors were assessed by postal questionnaire at baseline. Two years later, stressful life events during the study phase, social support, use of health services and current depression (BDI > or = 13) were similarly assessed.


RESULTS
Adverse childhood experiences were common among depressed women and these past experiences together with the use of health services were associated with recovery from depression. Financial difficulties and a poor subjective health status associated with non-recovery and current stressful life events increased the likelihood of depression on follow-up. Furthermore, the important variables explaining depression on follow-up were the quality of social support and the existence of prior depressive symptoms at baseline.


CONCLUSIONS
Our results suggest that women's current depression especially associates with stressful life events, insufficient social support, poor subjective health and financial difficulties. It seems possible that past adverse experiences predispose women to depression, but current stressful events actualize these symptoms. In addition, use of health services are associated with recovery in women who had ACEs.
Honkalampi
Kirsi
K
Department of Psychiatry, Research and Development Unit, Kuopio University Hospital, P.O. Box 1777, FIN-70211, Kuopio, Finland. kirsi.honkalampi@kuh.fi
Hintikka
Jukka
J
Haatainen
Kaisa
K
Koivumaa-Honkanen
Heli
H
Tanskanen
Antti
A
Viinamäki
Heimo
H
D002648:Child; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires