Social Psychiatry and Psychiatric Epidemiology

, Volume 46, Issue 12, pp 1303–1312 | Cite as

Specific medical conditions associated with clinically significant depressive symptoms in men

  • Evan Atlantis
  • Kylie Lange
  • Robert D. Goldney
  • Sean Martin
  • Matthew T. Haren
  • Anne Taylor
  • Peter D. O’Loughlin
  • Villis Marshall
  • Wayne Tilley
  • Gary A. Wittert
Original Paper

Abstract

Purpose

To define specific medical conditions associated with clinically significant depressive symptoms in men.

Methods

A cross-sectional study was conducted in a community-based sample of Australian men (N = 1,195, aged 35–80 years; for 2002–2005). Depression was defined by: (1) symptomatic depression (current symptoms) or (2) current prescription for antidepressant(s) or (3) previously diagnosed depression. Logistic regression was used to determine prevalence odds ratios (OR) for depression independently associated with an extensive range of demographic, lifestyle, and clinical factors. Adjusted population attributable risk (PAR%) estimates were also computed.

Results

Depression was significantly (ORs at P < 0.05) associated with previously diagnosed anxiety (12.0) and insomnia (4.4), not married (1.7), current smoker (1.7), low muscle strength tertile (1.7, P = 0.059), high triglycerides (1.6), high storage lower urinary tract symptoms (LUTS) tertile (1.8), past year general practitioner visits 5–9 (1.9), middle energy density tertile (0.4), and high systolic blood pressure (0.5). Significant PAR% estimates (at P < 0.05) were for previous anxiety (27.0%) and insomnia (16.1%), middle energy density tertile (−17.2%), high SBP (−23.5%), high triglycerides (15.2%), and high storage LUTS tertile (12.6%). Results strengthened when depression-related factors (previous anxiety and insomnia, psycholeptics, and cognition) were omitted, and became significant for CVD (OR 1.6; PAR 13.9%).

Conclusions

Medical conditions associated with depression in men include high triglycerides, low muscle strength, CVD, and LUTS. Depressed men are likely to use health services frequently, be current smokers, not be married, eat unhealthily, and report previous diagnosis of anxiety and insomnia; which has important implications for clinicians managing male patients.

Keywords

Depression Cardiovascular disease Muscle strength Triglycerides LUTS 

Supplementary material

127_2010_302_MOESM1_ESM.doc (172 kb)
Supplementary material 1 (DOC 172 kb)

References

  1. 1.
    ABS (2007) Catalogue No. 4326.0. National Survey of Mental Health and Wellbeing: summary of results. Australian Bureau of Statistics, CanberraGoogle Scholar
  2. 2.
    Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro JM, Vilagut G, Bromet EJ, Gluzman S, Webb C, Kessler RC, Merikangas KR, Anthony JC, Von Korff MR, Wang PS, Brugha TS, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell BE, Zaslavsky AM, Ustun TB, Chatterji S, Consortium WHOWMHS (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590PubMedCrossRefGoogle Scholar
  3. 3.
    Mathers CD, Vos ET, Stevenson CE, Begg SJ (2001) The burden of disease and injury in Australia. Bull WHO 79:1076–1084PubMedGoogle Scholar
  4. 4.
    Overland S, Glozier N, Sivertsen B, Stewart R, Neckelmann D, Krokstad S, Mykletun A (2008) A comparison of insomnia and depression as predictors of disability pension: the HUNT Study. Sleep 31:875–880PubMedGoogle Scholar
  5. 5.
    Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, Corey-Lisle PK (2003) The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry 64(12):1465–1475PubMedCrossRefGoogle Scholar
  6. 6.
    Mezuk B, Eaton WW, Albrecht S, Golden SH (2008) Depression and type 2 diabetes over the lifespan. Diabetes Care 31:2383–2390PubMedCrossRefGoogle Scholar
  7. 7.
    Atlantis E, Browning C, Sims J, Kendig H (2010) Diabetes incidence associated with depression and antidepressants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA). Int J Geriatr Psychiatry 25(7):688–696Google Scholar
  8. 8.
    Van der Koen K, van Hein H, Harm M, Haan M, Coen S, Aartjan B (2007) Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry 22:613–626CrossRefGoogle Scholar
  9. 9.
    Cavanagh JTO, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33:395–405PubMedCrossRefGoogle Scholar
  10. 10.
    Hawthorne G, Goldney R, Taylor AW (2008) Depression prevalence: is it really increasing? Aust N Z J Psychiatry 42:606–616PubMedCrossRefGoogle Scholar
  11. 11.
    Strine TW, Mokdad AH, Dube SR, Balluz LS, Gonzalez O, Berry JT, Manderscheid R, Kroenke K (2008) The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry 30:127–137PubMedCrossRefGoogle Scholar
  12. 12.
    Wang J, Schmitz N (2010) Does job strain interact with psychosocial factors outside of the workplace in relation to the risk of major depression? The Canadian National Population Health Survey. Soc Psychiatry Psychiatr Epidemiol [Epub ahead of print]Google Scholar
  13. 13.
    Verger P, Lions C, Ventelou B (2009) Is depression associated with health risk-related behaviour clusters in adults? Eur J Public Health:ckp057Google Scholar
  14. 14.
    Atlantis E, Baker M (2008) Obesity effects on depression: systematic review of epidemiological studies. In J Obes 32:881–891CrossRefGoogle Scholar
  15. 15.
    Everson-Rose SAP, Lewis TTP, Karavolos KMS, Dugan SAMD, Wesley DMPA, Powell LHP (2009) Depressive symptoms and increased visceral fat in middle-aged women. Psychosom Med 71:410–416PubMedCrossRefGoogle Scholar
  16. 16.
    Kinder LS, Carnethon MR, Palaniappan LP, King AC, Fortmann SP (2004) Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med 66:316–322PubMedCrossRefGoogle Scholar
  17. 17.
    Wichers MC, Myin-Germeys I, Jacobs N, Kenis G, Derom C, Vlietinck R, Delespaul P, Mengelers R, Peeters F, Nicolson N, Van Os J (2008) Susceptibility to depression expressed as alterations in cortisol day curve: a cross-twin, cross-trait study. Psychosom Med 70:314–318PubMedCrossRefGoogle Scholar
  18. 18.
    Amore M, Scarlatti F, Quarta AL, Tagariello P (2009) Partial androgen deficiency, depression and testosterone treatment in aging men. Aging Clin Exp Res 21:1–8PubMedGoogle Scholar
  19. 19.
    Kupelian V, Rosen RC, Link CL, McVary KT, Aiyer LP, Mollon P, Kaplan SA, McKinlay JB (2009) Association of urological symptoms and chronic illness in men and women: contributions of symptom severity and duration–results from the BACH Survey. J Urol 181:694–700PubMedCrossRefGoogle Scholar
  20. 20.
    John U, Meyer C, Rumpf H-J, Hapke U (2006) Psychiatric comorbidity including nicotine dependence among individuals with eating disorder criteria in an adult general population sample. Psychiatry Res 141:71–79PubMedCrossRefGoogle Scholar
  21. 21.
    Atlantis E, Ball K (2008) Association between weight perception and psychological distress. Int J Obes 32:715–721CrossRefGoogle Scholar
  22. 22.
    Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS, National Comorbidity Survey R (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 289:3095–3105PubMedCrossRefGoogle Scholar
  23. 23.
    Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B (2007) Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370:851–858PubMedCrossRefGoogle Scholar
  24. 24.
    Jansson-Fröjmark M, Lindblom K (2008) A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. J Psychosom Res 64:443–449PubMedCrossRefGoogle Scholar
  25. 25.
    Sachs-Ericsson N, Joiner T, Blazer DG (2008) The influence of lifetime depression on self-reported memory and cognitive problems: results from the National Comorbidity Survey-Replication. Aging Ment Health 12:183–192PubMedCrossRefGoogle Scholar
  26. 26.
    ABS (2004) Catalogue No. 3309.0.55.001. Suicides: recent trends, Australia. Australian Bureau of Statistics, CanberraGoogle Scholar
  27. 27.
    Pinto-Meza A, Fernández A, Bruffaerts R, Alonso J, Kovess V, De Graaf R, de Girolamo G, Matschinger H, Haro J (2010) Dropping out of mental health treatment among patients with depression and anxiety by type of provider: results of the European Study of the Epidemiology of Mental Disorders. Soc Psychiatry Psychiatr Epidemiol [Epub ahead of print]Google Scholar
  28. 28.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedGoogle Scholar
  29. 29.
    Silveira E, Taft C, Sundh V, Waern M, Palsson S, Steen B (2005) Performance of the SF-36 health survey in screening for depressive and anxiety disorders in an elderly female Swedish population. Qual Life Res 14:1263–1274PubMedCrossRefGoogle Scholar
  30. 30.
    Fuld PA (1980) Guaranteed stimulus-processing in the evaluation of memory and learning. Cortex 16:255–271PubMedGoogle Scholar
  31. 31.
    Greenlief CL, Margolis RB, Erker GJ (1985) Application of the Trail Making Test in differentiating neuropsychological impairment of elderly persons. Percept Mot Skills 61:1283–1289PubMedCrossRefGoogle Scholar
  32. 32.
    Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement: executive summary. Circulation 112:e285–e290CrossRefGoogle Scholar
  33. 33.
    Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB (1994) Construction of a surrogate variable for impotence in the Massachusetts male aging study. J Clin Epidemiol 47:457–467PubMedCrossRefGoogle Scholar
  34. 34.
    Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT (1992) The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 148:1549–1557; discussion 1564Google Scholar
  35. 35.
    Maislin G, Pack AI, Kribbs NB, Smith PL, Schwartz AR, Kline LR, Schwab RJ, Dinges DF (1995) A survey screen for prediction of apnea. Sleep 18:158–166PubMedGoogle Scholar
  36. 36.
    McNutt L-A, Wu C, Xue X, Hafner JP (2003) Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 157:940–943PubMedCrossRefGoogle Scholar
  37. 37.
    Sundar N, Stuart RL, Eric R (2007) A simple method of determining confidence intervals for population attributable risk from complex surveys. Stat Med 26:3229–3239CrossRefGoogle Scholar
  38. 38.
    Gaynes BN, Magruder KM, Burns BJ, Wagner HR, Yarnall KSH, Broadhead WE (1999) Does a coexisting anxiety disorder predict persistence of depressive illness in primary care patients with major depression? Gen Hosp Psychiatry 21:158–167PubMedCrossRefGoogle Scholar
  39. 39.
    Benetó A, Gomez-Siurana E, Rubio-Sanchez P (2009) Comorbidity between sleep apnea and insomnia. Sleep Med Rev 13:287–293PubMedCrossRefGoogle Scholar
  40. 40.
    Peppard PE, Szklo-Coxe M, Hla KM, Young T (2006) Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med 166:1709–1715PubMedCrossRefGoogle Scholar
  41. 41.
    Narkiewicz K, van de Borne PJ, Cooley RL, Dyken ME, Somers VK (1998) Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation 98:772–776PubMedGoogle Scholar
  42. 42.
    Barton DA, Dawood T, Lambert EA, Esler MD, Haikerwal D, Brenchley C, Socratous F, Kaye DM, Schlaich MP, Hickie I, Lambert GW (2007) Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk? J Hypertens 25:2117–2124PubMedCrossRefGoogle Scholar
  43. 43.
    Bao AM, Meynen G, Swaab DF (2008) The stress system in depression and neurodegeneration: Focus on the human hypothalamus. Brain Res Rev 57:531–553PubMedCrossRefGoogle Scholar
  44. 44.
    Schwartz DJ, Karatinos G (2007) For individuals with obstructive sleep apnea, institution of CPAP therapy is associated with an amelioration of symptoms of depression which is sustained long term. J Clin Sleep Med 3:631–635PubMedGoogle Scholar
  45. 45.
    Duncan B, Rees DI (2005) Effect of smoking on depressive symptomatology: a reexamination of data from the National Longitudinal Study of Adolescent Health. Am J Epidemiol 162:461–470PubMedCrossRefGoogle Scholar
  46. 46.
    Patton GC, Carlin JB, Coffey C, Wolfe R, Hibbert M, Bowes G (1998) Depression, anxiety, and smoking initiation: a prospective study over 3 years. Am J Public Health 88:1518–1522PubMedCrossRefGoogle Scholar
  47. 47.
    Ribeiro EB, Bettiker RL, Bogdanov M, Wurtman RJ (1993) Effects of systemic nicotine on serotonin release in rat brain. Brain Res 621:311–318PubMedCrossRefGoogle Scholar
  48. 48.
    Paul JK, Sandra EF, Marcus R (2001) Nicotine regulates 5-HT1A receptor gene expression in the cerebral cortex and dorsal hippocampus. Eur J Neurosci 13:1267–1271CrossRefGoogle Scholar
  49. 49.
    Xu C, He J, Jiang H, Zu L, Zhai W, Pu S, Xu G (2009) Direct effect of glucocorticoids on lipolysis in adipocytes. Mol Endocrinol 23:1161–1170PubMedCrossRefGoogle Scholar
  50. 50.
    Strawbridge WJ, Deleger S, Roberts RE, Kaplan GA (2002) Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol 156:328–334PubMedCrossRefGoogle Scholar
  51. 51.
    Rantanen T, Penninx BW, Masaki K, Lintunen T, Foley D, Guralnik JM (2000) Depressed mood and body mass index as predictors of muscle strength decline in old men. J Am Geriatr Soc 48:613–617PubMedGoogle Scholar
  52. 52.
    Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA (2008) Exercise for depression. Cochrane Database of Systematic Reviews:CD004366Google Scholar
  53. 53.
    Atlantis E, Chow C-M, Kirby A, Fiatarone Singh M (2004) An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial. Prev Med 39:424–434PubMedCrossRefGoogle Scholar
  54. 54.
    Hildrum B, Mykletun A, Stordal E, Bjelland I, Dahl AA, Holmen J (2007) Association of low blood pressure with anxiety and depression: the Nord-Trondelag Health Study. J Epidemiol Commun Health 61:53–58CrossRefGoogle Scholar
  55. 55.
    Hildrum B, Mykletun A, Holmen J, Dahl AA (2008) Effect of anxiety and depression on blood pressure: 11-year longitudinal population study. Br J Psychiatry 193:108–113PubMedCrossRefGoogle Scholar
  56. 56.
    Broadley AJM, Frenneaux MP, Moskvina V, Jones CJH, Korszun A (2005) Baroreflex sensitivity is reduced in depression. Psychosom Med 67:648–651PubMedCrossRefGoogle Scholar
  57. 57.
    Lana LW, James AB, Robert MC (2002) Association of anxiety with reduced baroreflex cardiac control in patients after acute myocardial infarction. Am Heart J 143:460–466CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Evan Atlantis
    • 1
    • 2
  • Kylie Lange
    • 3
  • Robert D. Goldney
    • 4
    • 5
  • Sean Martin
    • 2
  • Matthew T. Haren
    • 6
  • Anne Taylor
    • 6
  • Peter D. O’Loughlin
    • 1
    • 2
  • Villis Marshall
    • 2
  • Wayne Tilley
    • 1
    • 2
    • 7
  • Gary A. Wittert
    • 1
    • 2
    • 3
  1. 1.Royal Adelaide Hospital/Institute of Medical and Veterinary ScienceSouth Australia Health, Government of South AustraliaAdelaideAustralia
  2. 2.School of Medicine, Freemasons Foundation Centre for Men’s HealthThe University of AdelaideAdelaideAustralia
  3. 3.School of Medicine, Centre of Clinical Research Excellence in Nutritional Physiology, Interventions and OutcomesThe University of AdelaideAdelaideAustralia
  4. 4.Discipline of PsychiatryThe University of AdelaideAdelaideAustralia
  5. 5.Hanson Institute, SA PathologyRoyal Adelaide HospitalAdelaideAustralia
  6. 6.Division of Health Sciences, SANSOM InstituteUniversity of South AustraliaAdelaideAustralia
  7. 7.School of Medicine, Dame Roma Mitchell Cancer Research Laboratories and Discipline of MedicineThe University of AdelaideAdelaideAustralia

Personalised recommendations