Traumatic life events as predictors for depression in middle-aged men and women: A Finnish twin study

Abstract

ABSTRACTBackgroundWe examined the exposure to adulthood traumatic life events (TLEs) and analysed their associations with depression in women and men. Then we examined whether the associations of TLEs are independent of exposure loading and vulnerability including familial confounding.MethodsTotal of 8410 individuals (45% men, mean age 60 years) participated in the fourth survey of the population-based Finnish Twin Cohort conducted in 2011. Depression was assessed using the Center for Epidemiologic Studies Depression (CES-D) scale (cut-off value ≥20). Participants reported exposure to TLEs during adulthood. Logistic regression adjusted for multiple covariates was used as the individual-based analyses. The effect of shared familial factors was tested using conditional logistic regression in 399 twin pairs discordant for depression.ResultsDepression was more common in women (15%) than in men (11%). Men reported more traffic accidents (men: 11.8%, women: 7.4%), other serious accidents (11.8%, 5.8%), and violent crime (3.1%, 2.0%) whereas women reported more sexual assault (0.7%, 10.6%). Violent crime (Odds Ratio 3.86; 95% Confidence Intervals 2.59, 5.73), sexual assault (3.49; 2.67, 4.55), physical assault (3.10; 2.45, 3.93), and other serious accidents (1.36; 1.01, 1.85) were associated with depression. These associations, except other serious accidents, remained statistically significant after adjusting for multiple covariates including TLEs load and shared familial factors. The associations did not differ by sex.ConclusionsWomen and men differ in exposure to TLEs but, if exposed, they are equally vulnerable for depression. Because traumatic life events are robustly associated with depression, they should be considered in prevention and treatment.