title: Defining subgroups of low socioeconomic status women at risk for depressive symptoms: the importance of perceived stress and cumulative risks.
abstract: BACKGROUND
  Most disadvantaged women are exposed to risk factors for depression, but not all necessarily have an identical risk for this mental health problem. A better prediction of which low socioeconomic status (SES) women are most at risk for depressive symptoms can help target preventive interventions at high-risk subgroups most in need of support.
  
  
  OBJECTIVE
  Exploring which demographic, socioeconomic and psychological risk factors are associated with self-reported depressive symptoms in a sample of low-SES women and whether the number of risk factors might expose them to an accumulated risk.
  
  
  METHODS
  Between April 2005 and November 2007, 519 disadvantaged women from urban neighbourhoods in Maastricht, a southern Dutch city, participated in a cross-sectional survey on stress and depressive symptoms.
  
  
  RESULTS
  Lower education levels, no current employment and lower net monthly family incomes were socioeconomic risk factors associated with higher scores for depressive symptoms. The psychological risk factor 'perceived stress' had the highest explained variance and was most strongly associated with depressive symptoms. Women exposed to multiple risk factors across domains had a cumulated risk for depressive symptomatology.
  
  
  CONCLUSIONS
  Low-SES women who seem most eligible for targeted preventive action are those with cumulative risks. Depression prevention strategies for this population may benefit from focusing on perceived stress since this is an important modifiable risk factor.
authors.affiliation: INSERM, UMR_S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Paris, France Department of Health Promotion, Maastricht University, Maastricht, The Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands judith.van-der-waerden@inserm.fr.
authors.forename: Judith E B
authors.initials: JE
authors.lastname: van der Waerden
authors.affiliation: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Hoefnagels
authors.affiliation: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Clemens M H
authors.initials: CM
authors.lastname: Hosman
authors.affiliation: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Public Health Services South Limburg, Geleen, The Netherlands.
authors.forename: Maria W J
authors.initials: MW
authors.lastname: Jansen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000191:economics / Q000209:etiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D011203:Poverty / Q000191:economics / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000191:economics / Q000209:etiology* / Q000523:psychology; D055815:Young Adult
keywords: Prevention; depression; risk profile; socioeconomic disadvantage; women