Comparison of risk factors for the onset and maintenance of depression

Christian Bottomley, Irwin Nazareth, Francisco Torres-González, Igor Švab, Heidi Ingrid Maaroos, Mirjam I. Geerlings, Miguel Xavier, Sandra Saldivia, Michael King

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)


Background: Factors associated with depression are usually identified from cross-sectional studies. Aims: We explore the relative roles of onset and recovery in determining these associations. Method: Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months. Results: Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor's effect on onset is highly predictive of its impact on recovery. Conclusions: Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.

Original languageEnglish
Pages (from-to)13-17
Number of pages5
JournalBritish Journal of Psychiatry
Issue number1
Publication statusPublished - Jan 2010


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