Chronic and acute stress and the prediction of major depression in women

Abstract

Background: This study explored the relatively neglected role of chronic stress in major depression, examining the independent contributions of co-occurring chronic and acute stress to depression, whether chronic stress predicts acute life events, and whether the two types of stress interact such that greater chronic stress confers greater sensitivity-or resistance-to the depressive effects of acute stressors.

Methods: From a sample of 816 community women, those who had a major depression onset in the past 9 months and those without major depressive episodes (MDE) onset and with no history of current or recent dysthymic disorder were compared on interview-based measures of antecedent acute and chronic stress. Chronic stress interviews rated objective stress in multiple everyday role domains, and acute stress was evaluated with contextual threat interviews.

Results: MDE onset was significantly associated with both chronic and acute stress; chronic stress was also associated with the occurrence of acute events, and there was a trend suggesting that increased acute stress is more strongly associated with depression in those with high versus low chronic stress.

Conclusions: Results suggest the importance of including assessment of chronic stress in fully understanding the extent and mechanisms of stress-depression relationships.

Figure 1

Stress and probability of MDE. Probability of major depression is shown as a function of the level of prior acute and chronic stress. MDE, major depressive episode.