Stressful events and coping strategies associated with symptoms of depression: A Japanese general population survey.

BACKGROUND

The following question remains open: what has the strongest impact on symptoms of depression, experiencing multiple stressful events, being exposed to a specific stressful event, or having a maladaptive coping style?

METHOD

We conducted a cross-sectional survey with face-to-face interviews. Data from 2559 randomly-sampled adults living in Japan were analyzed. The participants were asked about stressful events (12 items) experienced in the previous month and their stress-coping strategies (16 items). Presence of symptoms of depression was defined using the Center for Epidemiologic Studies Depression scale. Logistic regression analysis was used to assess the associations of stressful events and stress-coping strategies with symptoms of depression.

RESULTS

The prevalence of symptoms of depression increased with the number of stressful events. Eight stressful events and five stress-coping strategies were positively associated with symptoms of depression. In the multiple logistic regression analysis for the items that showed a significant association with symptoms of depression, two stressful events ("Health/illness of self" and "Trouble with family members") and two stress-coping strategies ("Smoking" and "Bearing without action") remained significantly associated with symptoms of depression; however, the "dose effect" of the number of stressful events disappeared, suggesting that these stressful events and stress-coping strategies have a stronger association with symptoms of depression compared with experiencing multiple stressful events.

LIMITATIONS

Since this study was cross-sectional in design, causal relationships could not be determined.

CONCLUSION

Our findings may indicate the importance of focusing on types of stressful events and coping styles in developing preventive strategies for major depression.