Differential effects of lifetime stressors on major depressive disorder severity: a longitudinal community-based cohort study

• Published in: European psychiatry Vol. 67; no. 1; p. e66
• Main Authors: Su, Yingying, Li, Muzi, Caron, Jean, Li, Daqi, Meng, Xiangfei
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 04-10-2024
• Subjects: Adult; Adult Survivors of Child Abuse - psychology; Adult Survivors of Child Abuse - statistics & numerical data; Adverse Childhood Experiences - statistics & numerical data; Appetite; Child abuse & neglect; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Female; general psychopathology; Humans; Insomnia; Life Change Events; lifetime stressors; longitudinal data; Longitudinal Studies; major depressive disorder; Male; Marital status; Mental depression; Mental disorders; Mental health; Middle Aged; Questionnaires; Severity of Illness Index; Sleep disorders; Stress; Stress, Psychological - psychology; Substance abuse treatment; subtypes; Suicides & suicide attempts; Young Adult; major depressive disorder; lifetime stressors; general psychopathology; longitudinal data; subtypes
• ISSN: 0924-9338; 1778-3585; 1778-3585
• DOI: 10.1192/j.eurpsy.2024.1783

Stressors across the lifespan are associated with the onset of major depressive disorder (MDD) and increased severity of depressive symptoms. However, it is unclear how lifetime stressors are related to specific MDD subtypes. The present study aims to examine the relationships between MDD subtypes and stressors experienced across the lifespan while considering potential confounders.
Data analyzed were from the Zone d'Épidémiologie Psychiatrique du Sud-Ouest de Montréal (
= 1351). Lifetime stressors included childhood maltreatment, child-parent bonding, and stressful life events. Person-centered analyses were used to identify the clusters/profiles of the studied variables and multinomial logistic regression analyses were performed to examine the relationships between stressors and identified MDD subtypes. Intersectional analysis was applied to further examine how distal stressors interact with proximal stressors to impact the development of MDD subtypes.
There was a significant association between proximal stressors and melancholic depression, whereas severe atypical depression and moderate depression were only associated with some domains of stressful life events. Additionally, those with severe atypical depression and melancholic depression were more likely to be exposed to distal stressors such as childhood maltreatment. The combinations of distal and proximal stressors predicted a greater risk of all MDD subtypes except for moderate atypical depression.
MDD was characterized into four subtypes based on depressive symptoms and severity. Different stressor profiles were linked with various MDD subtypes. More specific interventions and clinical management are called to provide precision treatment for MDD patients with unique stressor profiles and MDD subtypes.