title: Long term life dissatisfaction and subsequent major depressive disorder and poor mental health.
abstract: BACKGROUND
  Poor mental health, especially due to depression, is one of the main public health problems. Early indicators of poor mental health in general population are needed. This study examined the relationship between long-term life dissatisfaction and subsequent mental health, including major depressive disorder.
  
  
  METHODS
  Health questionnaires were sent to a randomly selected population-based sample in 1998 and repeated in 1999 and 2001. In 2005, a clinically studied sub-sample (n = 330) was composed of subjects with (n = 161) or without (n = 169) repeatedly reported adverse mental symptoms at all three previous data collection times. Clinical symptom assessments were performed with several psychometric scales: life satisfaction (LS), depression (HDRS, BDI), hopelessness (HS), mental distress (GHQ), dissociative experiences (DES), and alexithymia (TAS). The long-term life dissatisfaction burden was calculated by summing these life satisfaction scores in 1998, 1999, 2001 and dividing the sum into tertiles. Psychiatric diagnoses were confirmed by SCID-I for DSM-IV in 2005. Logistic regression analyses were performed to assess the studied relationship.
  
  
  RESULTS
  The previous life dissatisfaction burden associated with adverse socio-demographic, life style and clinical factors. In adjusted logistic regression analyses, it was independently and strongly associated with subsequent major depressive disorder in 2005, even when the concurrent LS score in 2005 was included in the model. Excluding those with reported major depressive disorder in 1999 did not alter this finding.
  
  
  CONCLUSIONS
  MDD in 1999 was based on self-reports and not on structured interview and LS data in 2001-2005 was not available.
  
  
  CONCLUSIONS
  The life satisfaction burden is significantly related to major depressive disorder and poor mental health, both in cross-sectional and longitudinal settings.
authors.affiliation: Dept of Psychiatry, Kuopio University Hospital, Kuopio, Finland. teemu.rissanen@fimnet.fi
authors.forename: Teemu
authors.initials: T
authors.lastname: Rissanen
authors.forename: Heimo
authors.initials: H
authors.lastname: Viinamäki
authors.forename: Kirsi
authors.initials: K
authors.lastname: Honkalampi
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.forename: Jukka
authors.initials: J
authors.lastname: Hintikka
authors.forename: Tarja
authors.initials: T
authors.lastname: Saharinen
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
mesh_terms: D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010549:Personal Satisfaction; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index