Factors associated with the onset of an episode of depressive symptoms in the general population

Objectives: To determined the association between spinal pain, headache, health, demographic and socio-economic characteristics, and development of depressive symptomatology. Methods: A population-based, random sample of adults was surveyed and followed at 6 and 12 months. Individuals at risk of depression at baseline are the subjects of this article (n = 845). We used Cox proportional hazards models to measure the time-varying effects of demographic, socio-economic, and health status; comorbid medical conditions; spinal pain; and headaches on the development of depression. Results: After adjusting for baseline depressive symptoms and factors associated with nonresponse to follow-up, we found that spinal pain severity, younger age, marital status (separated/divorced/widowed), self-perceived poor health status, and comorbid neurologic and gastro-intestinal disease were associated with onset of a new episode of depression. Conclusions: Important predictors of depressive symptomatology include demographic characteristics, health problems, and pain problems. (C) 2003 Elsevier Inc. All rights reserved.