Do depressive symptoms adversely affect the lifestyle? Results of the WOBASZ study.

Background: The negative psychosocial risk factors for cardiovascular (CV) disease, such as low social support or depression, may adversely affect the lifestyle.

Aim: To evaluate the lifestyle in terms of anti-health behaviours in patients with depressive symptoms (DS) compared to individuals without DS.

Methods: A total of 6392 men and 7153 women aged 20-74 years were evaluated in the WOBASZ study [a multicentre nationwide study of the Polish population's health]). The presence of DS was assessed with Beck's Depression Inventory (BDI). Depressive symptoms were considered to be present if the patient scored at least 10 points on the BDI scale.

Results: The DS were present in 24% of men and 34% of women. In both groups, the mean age of subjects with DS was significantly higher compared to healthy individuals. Compared to healthy individuals, subjects with DS had a more unfavourable CV risk profile (hypertension, diabetes mellitus, obesity and hyperlipidaemia were significantly more prevalent among the subjects with DS), were characterised by a lower socioeconomic status and inhabited small administrative districts. Subjects with DS were also characterised by more anti-health lifestyles than healthy individuals. Of the 6 elements of anti-healthy lifestyle, 3 or more were observed in 18.8% of men with DS and 14.6% of men without DS (p < 0.0001) and in 17.5% of women with DS and 11.3% of women without DS (p < 0.0001). Significantly more men and women with DS than men and women without DS were regular smokers (men [M]: 42.3% vs 37.4%, p < 0.0007; women [W]: 25.6% vs 23.3%, p < 0.0346), were not physically active (M: 37.4% vs 30.2%, p < 0.0001; W: 43.4% vs 34.9%, p < 0.0001), consumed alcohol at least three times a week (M: 3.8% vs 1.7%, p < 0.0097; W: 0.3% vs 0.1%, p = 0.0349), were incompliant with their doctor's recommendations (M: 17.9% vs 12.3%, p < 0.0001; W: 22.2% vs 13.9%, p < 0.0001) and failed to have their blood pressure measured within the past year (M: 19.4% vs 15.0%, p < 0.0003; W: 15.1% vs 11.4%, p < 0.0001). The lack of physical activity and smoking, and - in women - regular consumption of alcohol, were demonstrated to be the lifestyle factors which were significantly and independently related to DS.

Conclusions: A high prevalence of DS, especially among women, has been observed in the Polish population. The DS were found in every fourth man and every third woman. In both groups, subjects with DS were characterised by more anti-health lifestyle compared to healthy individuals. Of all the analysed factors of anti-health lifestyle the following were significantly and independently associated with DS - lack of physical activity and smoking in both sexes and, additionally, regular alcohol consumption in women.