Depression and cause specific mortality in an ethnically diverse cohort from the UK: Eight year prospective study

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Title:	Depression and cause specific mortality in an ethnically diverse cohort from the UK: Eight year prospective study
Authors:	Das-Munshi, J;Chang, C-K;張慶國;Schofield, P;Stewart, R;Prince, M
Keywords:	All-cause mortality;depression;ethnicity;natural cause mortality;unipolar depression;unnatural cause mortality
Date:	2018-09
Issue Date:	2019-12-11 10:17:34 (UTC+8)
Abstract:	BACKGROUND: Depression is associated with increased mortality, however, little is known about its variation by ethnicity. METHODS: We conducted a cohort study of individuals with ICD-10 unipolar depression from secondary mental healthcare, from an ethnically diverse location in southeast London, followed for 8 years (2007-2014) linked to death certificates. Age- and sex- standardised mortality ratios (SMRs), with the population of England and Wales as a standard population were derived. Hazard ratios (HRs) for mortality were derived through multivariable regression procedures. RESULTS: Data from 20 320 individuals contributing 91 635 person-years at risk with 2366 deaths were used for analyses. SMR for all-cause mortality in depression was 2.55(95% CI 2.45-2.65), with similar trends by ethnicity. Within the cohort with unipolar depression, adjusted HR (aHRs) for all-cause mortality in ethnic minority groups relative to the White British group were 0.62(95% CI 0.53-0.74) (Black Caribbean), 0.53(95% CI 0.39-0.72) (Black African) and 0.69(95% CI 0.52-0.90) (South Asian). Male sex and alcohol/substance misuse were associated with an increased all-cause mortality risk [aHR:1.94 (95% CI 1.68-2.24) and aHR:1.18 (95% CI 1.01-1.37) respectively], whereas comorbid anxiety was associated with a decreased risk [aHR: 0.72(95% CI 0.58-0.89)]. Similar associations were noted for natural-cause mortality. Alcohol/substance misuse and male sex were associated with a near-doubling in unnatural-cause mortality risk, whereas Black Caribbean individuals with depression had a reduced unnatural-cause mortality risk, relative to White British people with depression. CONCLUSIONS: Although individuals with depression experience an increased mortality risk, marked heterogeneity exists by ethnicity. Research and practice should focus on addressing tractable causes underlying increased mortality in depression.
Relation:	Psychological Medicine, v.5, p.1-13
Appears in Collections:	[Department of Health and Welfare] Articles

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