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Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS)

Published online by Cambridge University Press:  27 January 2014

H. M. Kravitz ,
L. L. Schott ,
H. Joffe ,
J. M. Cyranowski  and
J. T. Bromberger
H. M. Kravitz*
Affiliation:
Departments of Psychiatry and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
L. L. Schott
Affiliation:
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
H. Joffe
Affiliation:
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
J. M. Cyranowski
Affiliation:
Departments of Psychology and Psychiatry, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, PA, USA
J. T. Bromberger
Affiliation:
Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
*
* Address for correspondence: Dr H. M. Kravitz, Rush University Medical Center, Department of Psychiatry, Rush West Campus, 2150 West Harrison Street, Chicago, IL 60612, USA. (Email: [email protected])
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Abstract

Background

In women, anxiety symptoms are common and increase during midlife, but little is known about whether these symptoms predict onsets of major depressive disorder (MDD) episodes. We examined whether anxiety symptoms are associated with subsequent episodes of MDD in midlife African-American and Caucasian women, and whether they confer a different risk for first versus recurrent MDD episodes.

Method

A longitudinal analysis was conducted using 12 years of data from the Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS). The baseline sample comprised 425 Caucasian (n = 278) and African American (n = 147) community-dwelling women, aged 46.1 ± 2.5 years. Anxiety symptoms measured annually using a self-report questionnaire were examined in relation to MDD episodes in the subsequent year, assessed with the SCID. Multivariable models were estimated with random effects logistic regression.

Results

Higher anxiety symptoms scores were associated with a significantly higher adjusted odds of developing an episode of MDD at the subsequent annual visit [odds ratio (OR) 1.47, p = 0.01], specifically for a recurrent episode (OR 1.49, p = 0.03) but non-significant for a first episode (OR 1.32, p = 0.27). There were no significant racial effects in the association between anxiety symptoms and subsequent MDD episodes.

Conclusions

Anxiety symptoms often precede MDD and may increase the vulnerability of midlife women to depressive episodes, particularly recurrences. Women with anxiety symptoms should be monitored clinically during the ensuing year for the development of an MDD episode.

Keywords

Anxietylongitudinalmajor depressive disordermidlife womenrace
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 12 , September 2014 , pp. 2593 - 2602
Copyright
Copyright © Cambridge University Press 2014 

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