Patterns and predictors of depression in residents of New York City

We aimed to characterize changing symptoms of depression in a population based cohort over a 30 month period and to determine the factors associated with positive diagnoses. This prospective study comprised 4 telephone interviews of 2282 subjects living in New York City recruited by random digit dialing. Approximately 25% of respondents met criteria for depression at one point in time and, of these, 40% met the criteria more than once. Almost 3% participants reported persistent symptoms consistent with major depression across the 30 month study period. The risk of depression was lowest for participants with neither a baseline diagnosis nor lifetime history, greater for those without a baseline diagnosis but giving a lifetime history, and greatest for subjects with a baseline diagnosis. Having depression at the previous interview, recent life stressors and traumatic events, poor physical health at previous interview, having a household income of less than $50,000 at baseline, being separated at baseline, and reporting lower levels of social support at baseline were all significantly associated with later symptoms of depression in multivariate longitudinal analysis. The association with lower levels of social support was stronger in subjects with recurring diagnoses. Our study highlights the good prognosis but recurring nature of depression among the general population. The findings suggest that social factors may play an important role in the development of affective disorders, and that these relationships may be influenced by individual susceptibility.