Bouncing back: remission from depression in a 12-year panel study of a representative Canadian community sample
- 392 Downloads
This study sought to investigate time to remission from depression in a community-based sample of adults followed for 12 years.
Data were derived from the National Population Health Survey (1994/5–2006/7 and 1996/7–2008/9). Fully 1,128 adults were included who were depressed at baseline according to DSM-III/CIDI-SF criteria. Kaplan–Meier and Cox proportional hazards procedures were used to determine time to remission and the demographic (e.g., gender and marital status), psychosocial (e.g., social support and adverse childhood experience) and health-related (e.g., pain, health conditions and alcohol use) factors with which it is associated.
More than three quarters of the sample (77 %) no longer screened positive for depression at 2 years, and nearly the entire sample (94 %) had remitted by 12 years. Adverse childhood experiences (i.e., childhood abuse and parental additions), lack of social support, the presence of pain and health conditions (i.e., migraines, arthritis and back pain) each predicted more time to remission. The only factor associated with time to remission in the multivariate analysis was a history of childhood physical abuse.
Most community members with depression get better after 2 years and nearly all will have remitted, at least once, by 12 years. The results of this study may help guide the development of interventions for chronic depression that focus on early prevention of childhood abuse.
KeywordsSurvival analysis CIDI-SF Childhood abuse Adverse childhood experiences
The first author (Esme Fuller-Thomson) would like to gratefully acknowledge support received from the Sandra Rotman Endowed Chair in Social Work. We wish to thank Statistics Canada and the Social Sciences and Humanities Council of Canada for permission to access the longitudinal form of the National Population Health Survey via the Research Data Center (RDC) at the University of Toronto. We are also grateful to the staff at the Toronto RDC for their help in accessing the data. The opinions expressed herein are our own and do not represent the views of Statistics Canada.
Conflict of interest
- 2.World Health Organization (2004) The global burden of disease: 2004 update. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html. Accessed April 9, 2013
- 6.Hirschfeld RMA (2000) Psychosocial Predictors of Outcome in Depression. http://www.acnp.org/G4/GN401000107/. Accessed June 20, 2013
- 16.Bockting CL, Spinhoven P, Koeter MW, Wouters LF, Schene AH, Depression Evaluation Longitudinal Therapy Assessment Study Group (2006) Prediction of recurrence in recurrent depression and the influence of consecutive episodes on vulnerability for depression: a 2-year prospective study. J Clin Psychiatry 67:747–755PubMedCrossRefGoogle Scholar
- 30.Ciudad A, Alvarez E, Roca M, Baca E, Caballero L, Garcia de Polavieja P et al (2012) Early response and remission as predictors of a good outcome of a major depressive episode at 12-month follow-up: a prospective, longitudinal, observational study. J Clin Psychiatry 73:185–191PubMedCrossRefGoogle Scholar
- 31.Fuller-Thomson E, Battiston M, Gadalla T, Shaked Y, Raza F (in press) Remission from depression among adults with arthritis: a 12-year follow-up of a population-based study. Depress Res Treat. http://www.hindawi.com/journals/drt/aip/
- 36.Health Statistics Division, Statistics Canada (1995) National Population Health Survey 1994-95: Overview. http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SurvId=3225&SurvVer=0&SDDS=3225&InstaId=15280&InstaVer=1&lang=en&db=imdb&adm=8&dis=2. Accessed June 20, 2013
- 37.Statistics Canada (2012) National Population Health Survey-Household Component—Longitudinal (NPHS). http://www23.statcan.gc.ca:81/imdb/p2SV.pl?Function=getSurvey&SDDS=3225&lang=en&db=imdb&adm=8&dis=2. Accessed March 11, 2013