title: Symptoms of depression and all-cause mortality in farmers, a cohort study: the HUNT study, Norway.
abstract: To explore all-cause mortality and the association between symptoms of depression and all-cause mortality in farmers compared with other occupational groups, using a prospective cohort design.
  
  
  
  We included adult participants with a known occupation from the second wave of the Nord-Trøndelag Health Study (Helseundersøkelsen i Nord-Trøndelag 2 (HUNT2) 1995-1997), Norway. Complete information on emigration and death from all causes was obtained from the National Registries. We used the depression subscale of the Hospital Anxiety and Depression Scale (HADS) to measure symptoms of depression. We compared farmers to 4 other occupational groups. Our baseline study population comprised 32 618 participants. Statistical analyses were performed using the Cox proportional hazards models.
  
  
  
  The estimated mortality risk in farmers was lower than in all other occupations combined, with a sex and age-adjusted HR (0.91, 95% CI 0.82 to 1.00). However, farmers had an 11% increased age-adjusted and sex-adjusted mortality risk compared with the highest ranked socioeconomic group (HR 1.11, 95% CI 0.98 to 1.25). In farmers, symptoms of depression were associated with a 13% increase in sex-adjusted and age-adjusted mortality risk (HR 1.13, 95% CI 0.88 to 1.45). Compared with other occupations this was the lowest HR, also after adjusting for education, marital status, long-lasting limiting somatic illness and lifestyle factors (HR 1.08, 95% CI 0.84 to 1.39).
  
  
  
  Farmers had lower all-cause mortality compared with the other occupational groups combined. Symptoms of depression were associated with an increased mortality risk in farmers, but the risk increase was smaller compared with the other occupational groups.
authors.affiliation: Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
authors.forename: Jon Magne
authors.initials: JM
authors.lastname: Letnes
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, the Norwegian University of Science and Technology (NTNU), Levanger, Norway.
authors.forename: Magnhild Oust
authors.identifier: 0000-0001-6439-051X
authors.initials: MO
authors.lastname: Torske
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice, The Norwegian University of Science and Technology, Trondheim, Norway Department of Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Hilt
authors.affiliation: Faculty of Medicine, Department of Public Health and General Practice, The Norwegian University of Science and Technology, Trondheim, Norway Forensic Department, Research Centre Bröset St. Olav's University Hospital Trondheim, Trondheim, Norway.
authors.forename: Johan Håkon
authors.initials: JH
authors.lastname: Bjørngaard
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, the Norwegian University of Science and Technology (NTNU), Levanger, Norway Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
authors.forename: Steinar
authors.initials: S
authors.lastname: Krokstad
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000401:mortality; D003863:Depression / Q000401:mortality / Q000523:psychology; D004522:Educational Status; D000067565:Farmers / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009784:Occupational Diseases / Q000401:mortality / Q000523:psychology; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012907:Smoking / Q000401:mortality; D012959:Socioeconomic Factors
keywords: EPIDEMIOLOGY; MENTAL HEALTH; OCCUPATIONAL & INDUSTRIAL MEDICINE; PUBLIC HEALTH; SOCIAL MEDICINE