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. 2015 Jun;131(6):465-71.
doi: 10.1111/acps.12395. Epub 2015 Feb 4.

The differential influence of life stress on individual symptoms of depression

E I Fried  1 , R M Nesse  2 , C Guille  3 , S Sen  4
Affiliations

The differential influence of life stress on individual symptoms of depression

E I Fried et al. Acta Psychiatr Scand. 2015 Jun.

Abstract

Objective: Life stress consistently increases the incidence of major depression. Recent evidence has shown that individual symptoms of major depressive disorder (MDD) differ in important dimensions such as their genetic and etiological background, but the impact of stress on individual MDD symptoms is not known. Here, we assess whether stress affects depression symptoms differentially.

Method: We used the chronic stress of medical internship to examine changes of the nine Diagnostic and Statistical Manual (DSM)-5 criterion symptoms for depression in 3021 interns assessed prior to and throughout internship.

Results: All nine depression symptoms increased in response to stress (all P < 0.001), on average by 173%. Symptom increases differed substantially from each other (P < 0.001), with psychomotor problems (289%) and interest loss (217%) showing the largest increases, and suicidal ideation (146%) and sleep problems (52%) the smallest. Symptoms also differed in their severities under stress (P < 0.001): Fatigue, appetite problems and sleep problems were most prevalent; psychomotor problems and suicidal ideation were least prevalent.

Conclusion: Stress differentially affects the DSM-5 depressive symptoms. Analyses of individual symptoms reveal important insights obfuscated by sum-scores.

Keywords: depressive symptoms; internship; life stress; major depressive disorder.

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Figures

Fig. 1
Fig. 1
Depression symptoms at baseline and under stress.
Fig. 2
Fig. 2
Symptom change over time.
See this image and copyright information in PMC

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