@article{ref1,
title="The predictors of depression in a longitudinal cohort of community dwelling rural adults in Australia",
journal="Social psychiatry and psychiatric epidemiology",
year="2019",
author="Handley, Tonelle E. and Rich, Jane and Lewin, Terry J. and Kelly, Brian J.",
volume="54",
number="2",
pages="171-180",
abstract="PURPOSE: Many major studies of depression in Australia are under-representative of rural and remote residents, limiting the generalizability of their findings. This study explores the contributions of a range of individual, social, and community factors to the trajectory of depressive symptoms among a cohort of rural and remote residents. <br><br>METHODS: Data from four waves of the Australian Rural Mental Health Study (baseline n = 2639), a 5 year longitudinal study of rural community residents, were examined within generalized linear mixed models to predict depressive symptoms. Depression was measured using the PHQ-9, with key correlates including social support, employment status, financial wellbeing, neuroticism, and rural community factors. <br><br>RESULTS: Moderate-to-severe depression was reported by 6.3% of the baseline sample. Being permanently unable to work resulted in over a threefold increase in the odds of depression at the following survey wave. Self-rated financial hardship was associated with a fourfold increase in the odds of future depression, as was a high level of community concerns. Neuroticism and tobacco use also made a significant independent contribution to future depressive symptoms. Interpersonal support was a protective factor, reducing the odds of next-wave depression by 64%. <br><br>CONCLUSION: Financial and employment-related difficulties appear to be important risk factors for depression, and targeting individuals experiencing such difficulties may be an effective means of reducing depression among certain sub-groups. Strategies to prevent depression in rural and remote Australia may benefit from a focus on interpersonal and community-level support, as the effects of this support are lasting and contribute to a reduced likelihood of depressive episodes in future years.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-018-1591-1",
url="http://dx.doi.org/10.1007/s00127-018-1591-1"
}