The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries.
Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. However, few longitudinal evidence of these relationships has been collected in emerging countries. The present study aims i) to analyse whether people with unhealthy lifestyles are more likely to develop depression, and ii) to examine whether depressed people with unhealthy lifestyles are more likely to remain depressed. A total of 7908 participants from Ghana, India, Mexico and Russia were firstly evaluated in the World Health Organization's Study on Global AGEing and Adult Health (SAGE) Wave 0 (2002-2004) and re-evaluated in 2007-2010 (Wave 1). Data on tobacco use, alcohol drinking and physical activity, were collected. Logistic regressions models were employed to assess whether baseline unhealthy lifestyles were related to depression in Wave 1, among people without 12-month depression in Wave 0 and any previous lifetime diagnosis of depression, and to 12-month depression at both study waves (persistent depression).



Baseline daily and non-daily smoking was associated with depression in Wave 1. Low physical activity and heavy alcohol drinking were associated with persistent depression.



Unhealthy lifestyles and depression are also positively related in emerging countries. Smoking on a daily and non-daily basis was longitudinally related to depression. Depressed people with low physical activity and with heavy drinking patterns were more likely to become depressed over time. Several interpretations of these results are given. Further studies should check whether a reduction of these unhealthy lifestyles leads to lower depression rates and/or to a better clinical prognosis of depressed people.
Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.
Maria
M
Cabello
Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.|Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
Marta
M
Miret
Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.|Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
Francisco Felix
FF
Caballero
Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
Somnath
S
Chatterji
Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
Nirmala
N
Naidoo
Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.|Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia.
Paul
P
Kowal
National Centre for Epidemiology and Population Health (NCEPH), Australian National University, Canberra, ACT, Australia.
Catherine
C
D'Este
Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain. joseluis.ayuso@uam.es.|Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain. joseluis.ayuso@uam.es.|Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Diego de Leon, 62, Madrid, 28006, España. joseluis.ayuso@uam.es.
Jose Luis
JL
Ayuso-Mateos
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D000073865:Cigarette Smoking / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D005869:Ghana / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology / Q000208:ethnology; D008019:Life Style / Q000208:ethnology*; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D012426:Russia / Q000453:epidemiology / Q000208:ethnology; D014944:World Health Organization / Q000458:organization & administration
Depression; Lifestyles; Longitudinal study; Middle-income countries