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. 2022 Jul 20;17(7):e0271716.
doi: 10.1371/journal.pone.0271716. eCollection 2022.

Association between life events and later depression in the population-based Heinz Nixdorf Recall study-The role of sex and optimism

Janine Gronewold  1 , Ela-Emsal Duman  1 , Miriam Engel  2 , Miriam Engels  3 , Johannes Siegrist  3 , Raimund Erbel  2 , K-H Jöckel  2 , Dirk M Hermann  1
Affiliations

Association between life events and later depression in the population-based Heinz Nixdorf Recall study-The role of sex and optimism

Janine Gronewold et al. PLoS One. .

Abstract

Background: The association between life event stress and depressive symptoms has not been analyzed in the general population before.

Methods: In the population-based Heinz Nixdorf Recall study, we assessed the association of 1.) the presence of important life events and 2.) life event stress, with the amount of depressive symptoms in univariable linear regressions and in multivariable regressions adjusted for age and sex (model 1) and age, sex and optimism as important determinants of coping with life events (model 2). Presence of life events and life event stress were assessed with the Social Readjustment Rating Scale (SRRS), optimism with the Life Orientation Test-Revised (LOT-R), and depressive symptoms with the 15-item Center for Epidemiological Studies Depression Scale (CES-D).

Results: Of the total cohort of 4,814 participants, 1,120 had experienced important life events during the previous 6 months. Presence of important life events was significantly associated with higher CES-D scores (B = 2.6, 95%CI = 2.2 to 3.0, p < .001; model 2) compared to absence of life events. Associations were stronger for women than for men and for pessimists than for optimists. Among the participants with important life events, median (Q1; Q3) stress-score was 45.0 (39.0; 63.0). Stress-scores >Q3 were significantly associated with higher CES-D scores (2.2, 1.1 to 3.3, < .001) with a stronger association in pessimists than in optimists.

Conclusions: Experiencing life-changing events is associated with depression. Women and individuals with pessimistic personality are especially vulnerable which should be considered in prevention strategies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of the Heinz-Nixdorf Recall analyses samples.
SRRS, Social Readjustment Rating Scale.
Fig 2
Fig 2. Box and whisker plots demonstrating Center for Epidemiological Studies Depression Scale (CES-D) depression score for presence and absence of important life events in the total cohort and stratified by age (young ≙ ≤65 years vs old ≙ >65 years), sex (men vs women), and optimism (optimists ≙Life Orientation Test-Revised (LOT-R) score >18 vs pessimists ≙ LOT-R score ≤18).
The horizontal line in each box represents the median with the box representing the interquartile range (Q3-Q1) and the whiskers representing the total range of the data (max-min).
Fig 3
Fig 3. Box and whisker plots demonstrating Center for Epidemiological Studies Depression Scale (CES-D) depression score for Social Readjustment Rating Scale (SRRS) total score >Q3 and ≤Q3 (≙>63 vs ≤63), representing high and low life event stress.
Values are shown for the total cohort and stratified by age (young ≙ ≤65 years vs old ≙ >65 years), sex (men vs women) and optimism (optimists ≙Life Orientation Test-Revised (LOT-R) score >18 vs pessimists ≙ LOT-R score ≤18). The horizontal line in each box represents the median with the box representing the interquartile range (Q3-Q1) and the whiskers representing the total range of the data (max-min).
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