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The development of an environmental risk score using Swedish National Registers and its impact on subsequent episodes of major depression

Kendler, Kenneth S. LU ; Lönn, Sara L. LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2025) In Psychological Medicine 55.
Abstract

Background Stressful life events (SLEs) increase the risk for subsequent major depression (MD) episodes. Most prior studies of SLEs utilized questionnaires or interview-based assessments. We sought to develop and evaluate an environmental risk score (ERS) for MD from multiple classes of SLEs obtained from national Swedish registries. Methods We assessed, in the entire adult population of Sweden (n = 7,105,712), the occurrence of 52 categories of SLEs derived from registry information for the 6 months prior to January 9, 2010 and the risk for MD registration over the subsequent 6 months. Weights for our ERS were obtained from a random half of our sample and ERS and its relationship to MD risk was evaluated in the second half. Results The... (More)

Background Stressful life events (SLEs) increase the risk for subsequent major depression (MD) episodes. Most prior studies of SLEs utilized questionnaires or interview-based assessments. We sought to develop and evaluate an environmental risk score (ERS) for MD from multiple classes of SLEs obtained from national Swedish registries. Methods We assessed, in the entire adult population of Sweden (n = 7,105,712), the occurrence of 52 categories of SLEs derived from registry information for the 6 months prior to January 9, 2010 and the risk for MD registration over the subsequent 6 months. Weights for our ERS were obtained from a random half of our sample and ERS and its relationship to MD risk was evaluated in the second half. Results The ERS was robustly related to risk for subsequent MD episodes. Women were more sensitive to the depressogenic effect of the ERS than men. Those with prior episodes of MD had larger absolute increases in MD risk from our ERS than those without previous episodes. Genetic risk for MD was associated with a greater sensitivity to the depressogenic effects of the ERS. A co-sibling control analysis suggested that most, but not all, of the association between ERS and subsequent risk for MD was causal. Conclusions Valid measures of SLEs that predispose to risk for MD can be assessed from high-quality registry data. While not all event categories (e.g. interpersonal or romantic difficulties) can be assessed, this method avoids problems with accurate dating and recall bias and can be performed in very large samples.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
co-sibling control, environmental risk scores, genetic risk, major depression, stressful life events
in
Psychological Medicine
volume
55
article number
1 10
publisher
Cambridge University Press
external identifiers
  • pmid:40051281
  • scopus:86000697851
ISSN
0033-2917
DOI
10.1017/S0033291725000583
language
English
LU publication?
yes
id
6489cbb6-12c7-4b99-9436-805df8c264fa
date added to LUP
2025-06-11 13:45:15
date last changed
2025-12-11 06:48:13
@article{6489cbb6-12c7-4b99-9436-805df8c264fa,
  abstract     = {{<p>Background Stressful life events (SLEs) increase the risk for subsequent major depression (MD) episodes. Most prior studies of SLEs utilized questionnaires or interview-based assessments. We sought to develop and evaluate an environmental risk score (ERS) for MD from multiple classes of SLEs obtained from national Swedish registries. Methods We assessed, in the entire adult population of Sweden (n = 7,105,712), the occurrence of 52 categories of SLEs derived from registry information for the 6 months prior to January 9, 2010 and the risk for MD registration over the subsequent 6 months. Weights for our ERS were obtained from a random half of our sample and ERS and its relationship to MD risk was evaluated in the second half. Results The ERS was robustly related to risk for subsequent MD episodes. Women were more sensitive to the depressogenic effect of the ERS than men. Those with prior episodes of MD had larger absolute increases in MD risk from our ERS than those without previous episodes. Genetic risk for MD was associated with a greater sensitivity to the depressogenic effects of the ERS. A co-sibling control analysis suggested that most, but not all, of the association between ERS and subsequent risk for MD was causal. Conclusions Valid measures of SLEs that predispose to risk for MD can be assessed from high-quality registry data. While not all event categories (e.g. interpersonal or romantic difficulties) can be assessed, this method avoids problems with accurate dating and recall bias and can be performed in very large samples.</p>}},
  author       = {{Kendler, Kenneth S. and Lönn, Sara L. and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0033-2917}},
  keywords     = {{co-sibling control; environmental risk scores; genetic risk; major depression; stressful life events}},
  language     = {{eng}},
  publisher    = {{Cambridge University Press}},
  series       = {{Psychological Medicine}},
  title        = {{The development of an environmental risk score using Swedish National Registers and its impact on subsequent episodes of major depression}},
  url          = {{http://dx.doi.org/10.1017/S0033291725000583}},
  doi          = {{10.1017/S0033291725000583}},
  volume       = {{55}},
  year         = {{2025}},
}