title: Depressive symptoms as a risk factor for unintentional injury: a cohort study in a rural county.
abstract: OBJECTIVE
  The authors used data from a population based prospective cohort study to determine if depressive symptoms predicted incidence of unintentional injury.
  
  
  METHODS
  The Keokuk County Rural Health Study, based in Iowa, is a prospective cohort study of health status that includes injury outcomes. Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale at the beginning of the study on 1493 participants. Quarterly follow up phone calls were made to measure injury incidence.
  
  
  RESULTS
  471 injuries were reported for an overall injury rate of 9.8 per 100 person-years. Crude injury rates were significantly higher for those with depressive symptoms (p = 0.0003). Those with depressive symptoms had a 41% increased risk for injury after controlling for antidepressant medication use, gender, prior injury, income, and sleepiness (RR = 1.41, 95% CI 1.10 to 1.80). Depressive symptoms remained a risk factor for injury regardless of current antidepressant medication use (no medication use, RR = 1.43, 95% CI 1.09 to 1.88; medication use, RR = 1.31, 95% CI 0.76 to 2.26).
  
  
  CONCLUSIONS
  Depressive symptoms were found to be risk factors for unintentional injury. Medical practitioners should consider talking about safety with their patients, especially those reporting symptoms of depression, and recognize that an increased risk for injury remains until the depressive symptoms subside.
authors.affiliation: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA. hope-tiesman@uiowa.edu
authors.forename: H M
authors.initials: HM
authors.lastname: Tiesman
authors.forename: C
authors.initials: C
authors.lastname: Peek-Asa
authors.forename: P
authors.initials: P
authors.lastname: Whitten
authors.forename: N L
authors.initials: NL
authors.lastname: Sprince
authors.forename: A
authors.initials: A
authors.lastname: Stromquist
authors.forename: C
authors.initials: C
authors.lastname: Zwerling
mesh_terms: D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000150:complications*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007484:Iowa; D008297:Male; D008875:Middle Aged; D012423:Rural Health; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*