title: Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study.
abstract: Little is known about the course of depression in midlife women. This study aims to identify factors that distinguish risk factors for persistent or recurrent depression from those of a milder course across 13-years of follow-up.
  
  
  
  297 Black and White premenopausal women aged 42-52 were enrolled at the Study of Women's Health Across the Nation Pittsburgh site. Psychiatric interviews obtained information on lifetime psychiatric diagnoses at baseline and occurrences of depression annually. We identified four depression patterns: 91(31%) had Persistent/recurrent major depressive disorder (MDD), 27(9%) Single Episode MDD, 35(12%) Minor Depression (minD) only, 144(48%) No Depression. We compared baseline risk factors for the Persistent/recurrent MDD group with each of the other three.
  
  
  
  A lifetime history of major or minor depression (p-values =.001-.08) and 2+ very upsetting life events in the previous year (p-values=.003-.04) were more likely to be reported by women in the Persistent/recurrent group than in the other three. The Persistent/recurrent group was more likely to report a family history of depression (p=.03) than the MinD group, and to report current sleep problems (p=.002) at baseline than the Single Episode MDD group.
  
  
  
  Small numbers of women with minD or a Single Episode MDD. Childhood maltreatment and family depression history were retrospectively reported.
  
  
  
  A Persistent/recurrent depression course is common during midlife. In addition to personal and family histories of depression, providers of midlife health care should recognize that current sleep problems and recent very upsetting events are strong risk factors for a pernicious depression course.
authors.affiliation: Department of Epidemiology and Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, USA. Electronic address: brombergerjt@upmc.edu.
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.affiliation: Department of Psychiatry and Department of Preventive Medicine, Rush University, Medical Center, Chicago, IL, USA.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Ada
authors.initials: A
authors.lastname: Youk
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Schott
authors.affiliation: Department of Psychiatry, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Hadine
authors.initials: H
authors.lastname: Joffe
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D003863:Depression / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008603:Mental Health; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000523:psychology; D016387:Women's Health
keywords: Depressive disorders; Longitudinal; Midlife women; Risk factors