Causal and pathoplastic risk factors of depression: findings of the Tampere Depression Project

Abstract

Factors associated with low self-esteem in non-depressive subjects increase the individual's vulnerability to depression (causal risk factors), and factors correlated to low self-esteem in depressive subjects make the current disorder more severe (pathoplastic risk factors). Using the Rosenberg Self-Esteem Scale and Depression Scale we intended to explore correlates of low self-esteem in non-depressive and depressive subjects in a random sample of 1643 individuals attending community health centres in Central Finland. According to our study, self-esteem in non-depressive men was affected mainly by poor socioeconomic situation; in depressive men particularly low self-esteem was associated with negative family factors. Low self-esteem in non-depressive women was correlated to poor socioeconomic situation, poor health, and negative family factors. In depressive women self-esteem was affected by poor physical and poor mental health. Taking into consideration causal and pathoplastic risk factors, general practitioners can improve recognition of depression. By paying attention to pathoplastic factors, it is possible to improve detection of more severe forms of depression.