Negative life events and the relationship with depression: cross-sectional and prospective analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Author(s)

Simone Vieira da Silva

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2024-08-08

Examining board members

Isabela Judith Martins Benseñor; Lucas Borrione; Danielle Bivanco de Lima

• Advisor: Isabela Judith Martins Benseñor

Abstract

There is little data on the relationship between negative life events and prevalent/incident depression concerning the different age groups. In addition, gender differences may interfere with this association. This study aims to assess the association between the negative life events and the prevalence/incidence of depression according to age groups and gender, using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ELSA-Brasil is a prospective, multicenter cohort study of 15,105 civil servants from six Brazilian states capitals, aged between 35 and 74. Cross-sectional and prospective analyses (four/eight years) took place according to age strata at baseline 1st (35-44), 2nd (45-54), 3rd (55-64), and 4th (65-74) and gender (man/woman). The exposure variables were negative life events in the last year (robbery, hospitalization, death of a close relative, financial hardship, and rupture of a love relationship) collected at baseline. The outcome was depression assessed at the start of the study (prevalent) and the four/eight-year follow-up (incident). We built logistic models (odds ratio [OR], 95% confidence interval [95%CI]) in the cross-sectional analysis and Poisson regression models (relative risk [RR], 95%CI) in the prospective one. Robbery, hospitalization, financial hardship, and rupture of a love relationship were associated with prevalent depression and were concentrated in the 35-44 age group, while for incident depression the association of hospitalization, death of a close relative, and financial hardship were concentrated in the 45-54 age group. Financial hardship was the most prevalent negative event associated with depression in all four age groups: 1st) OR 2.77 (95%CI: 1.83-4.19); 2nd) OR 1.71 (95%CI: 1.26-2.34); 3rd) OR 1.68 (95%CI: 1.15-2.46); and 4th) OR 4.07 (95%CI: 1.24-13.34); and incident depression: 1st) RR 1.45 (95%CI: 1.09-1.93); 2nd) RR 1.46 (95%CI: 1.15-1.84); and 3rd) RR 1.97 (95%CI: 1.38-2.82). Rupture of a love relationship was only associated with prevalent depression, while the death of a close relative was only associated with incident depression. In terms of gender, women reported more negative life events compared to men. The negative life events associated to prevalent depression to men were hospitalization (OR 1.83; 95%CI: 1.16-2.91), financial hardship (OR 2.42; 95%CI: 1.69-3.49), rupture of a love relationship (OR 2.54; 95%CI: 1.50-4.29), and any negative event (OR 2.30; 95%CI: 1.59-3.35), and to women, Robbery (OR 1.81, 95%CI: 1.31-2.49), hospitalization (OR 1.46; 95%CI: 1.11-1.92), financial hardship (OR 1.76; 95%CI: 1.43-2.17), Rupture of a love relationship (OR 1.66; 95%CI: 1.20-2.32), and any negative event (OR 1.65; 95%CI: 1.34-2.04). For incident depression, only financial hardship(RR 2.09; 95%CI: 1.55-2.83) was associated with depression to men, while to women, were associated robbery (RR 1.54; 95%CI: 1.16-2.04), hospitalization (RR 1.36; 95%CI: 1.07-1.74), financial hardship (RR 1.37; 95%CI: 1.14-1.65), and any negative event (RR 1.25; 95%CI: 1.04-1.49). No association was found between the death of a close relative and prevalent/incident depression in either gender. The association between negative life events and depression was concentrate in younger people, and the greatest impact was in women, although this association was present to men and women (AU)

• FAPESP's process: 21/09833-1 - Negative life events and the relationship with depression: cross-sectional and prospective analysis of the Longitudinal Study of Adult Health (ELSA-Brasil
• Grantee: Simone Vieira da Silva
• Support Opportunities: Scholarships in Brazil - Master