Table 13.6-3. Risk factors for development of depression

Individual

Psychological

Chronic medical condition

(9.3%-23.0% of patients with chronic physical disease have comorbid depression compared to 3.2% without chronic disease; P <0.0001)

CHF (OR, 1.96; 95% CI, 1.23-3.11)

HTN (OR, 2.00; 95% CI, 1.74-2.31)

DM (OR, 1.96; 95% CI, 1.59-2.42)

CAD (OR, 2.30; 95% CI, 1.94-2.68)

CVA (OR, 3.15; 95% CI, 2.33-4.25)

COPD (OR, 3.21; 95% CI, 2.72-3.79)

ESRD (OR, 3.56; 95% CI, 2.61-4.87)

Any chronic condition (OR, 2.61; 95% CI, 2.31-2.94)

Migraine (RR, 1.53; 95% CI, 1.35-1.74)

Headache (RR, 1.44; 95% CI, 1.32-1.56)

Cancer (HR, 3.55; 95% CI, 2.79-4.52)

Chronic lung disease (HR, 2.21; 95% CI, 1.64-2.79)

Heart disease (HR, 1.45; 95% CI, 1.09-1.93)

Arthritis (HR, 1.46; 95% CI, 1.11-1.92)

Maltreatment in childhood

Emotional abuse (F/M: OR, 2.7/2.5; 95% CI, 2.3-3.2/1.9-3.2)

Physical abuse (F/M: OR, 2.1/1.6; 95% CI, 1.8-2.4/1.4-1.9)

Sexual abuse (F/M: OR, 1.8/1.6; 95% CI, 1.5-2.0/1.3-2.0)

Witnessed interpersonal violence (F/M: OR, 2.1/1.5; 95% CI, 1.8-2.5/1.2-1.9)

Female sex (OR, 1.83; 95% CI, 1.43-2.35; P <0.001)

Stressful life events

Sleep disorder

Insomnia (OR, 4.0; 95% CI, 2.2-7.0)

Hypersomnia (OR, 2.9; 95% CI, 1.5-5.6)

Recent bereavement (10%-20% of bereaved population develop clinical depression)

Positive family history

One parent affected (OR, 2.7; 95% CI, 2.1-3.5)

Two parents affected (OR, 3.0; 95% CI, 2.2-4.1)

Substance use and addictions

Ethanol (OR, 1.50; 95% CI, 1.17-1.92; P <0.001)

Marijuana (OR, 1.41; 95% CI, 1.21-1.65; P <0.001)

Other illicit drugs (OR, 1.65; 95% CI, 1.34-2.02, P <0.001)

Low socioeconomic status (low education/income/social status/combination) (OR, 1.81; 95% CI, 1.57-2.10, P <0.001)

CAD, chronic artery disease; CHF, chronic heart failure; CI, confidence interval; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; DM, diabetes mellitus; ESRD, end-stage renal disease; F, female; HR, hazard ratio; HTN, hypertension; M, male; OR, odds ratio; RR, relative risk.