title: Comparison of risk factors for the onset and maintenance of depression.
abstract: BACKGROUND
  Factors associated with depression are usually identified from cross-sectional studies.
  
  
  OBJECTIVE
  We explore the relative roles of onset and recovery in determining these associations.
  
  
  METHODS
  Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months.
  
  
  RESULTS
  Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor's effect on onset is highly predictive of its impact on recovery.
  
  
  CONCLUSIONS
  Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
authors.affiliation: Department of Primary Care and Population Sciences, University College London, UK. christian.bottomley@lshtm.ac.uk
authors.forename: Christian
authors.initials: C
authors.lastname: Bottomley
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres-González
authors.forename: Igor
authors.initials: I
authors.lastname: Svab
authors.forename: Heidi-Ingrid
authors.initials: HI
authors.lastname: Maaroos
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
authors.forename: Miguel
authors.initials: M
authors.lastname: Xavier
authors.forename: Sandra
authors.initials: S
authors.lastname: Saldivia
authors.forename: Michael
authors.initials: M
authors.lastname: King
mesh_terms: D017668:Age of Onset; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors