Associated factors with major depression: a path analysis on NHANES 2013–2014 study

ABSTRACT

Depression is a common mental disorder. The purpose of this study was to survey the direct and indirect effects of associated factors with major depression (MD) among the population aged 18 years and older of the NHANES 2013–2014. The study was based on a sample of the National Health and Nutrition Examination Survey data, including 5393 people. To detect MD, the Patient Health Questionnaire (PHQ-9) was used. Path analysis with Mplus software was used to perform analyses. The prevalence of MD was 6.9% in men and 12.4% in women. The final model was fitted well with sample data (p = 0.00; RMSEA = 0.05; CFI = 0.89; TLI = 0.77; WRMR = 1.93 in men and p = 0.00; RMSEA = 0.05; CFI = 0.92; TLI = 0.86; WRMR = 2.03 in women). Income, body mass index, chronic diseases and sleep disorder in both men and women and HDL cholesterol and drug use only in women have a direct effect on MD. Income, body mass index, smoking, and chronic diseases have an indirect effect on MD. Sleep disorder has the greatest total effect on MD. It is necessary to pay attention to these effective factors in control of major depression.

KEYWORDS:

• Major depression
• associated factors
• path analysis
• categorical variables
• NHANES

Acknowledgements

This article is based on the master’s thesis of the first author. The authors wish to thank the United States National Center for Health Statistics for building and maintaining national data on important health issues. Data from the National Health and Nutrition Examination Survey (NHANES) are freely available on the Centers for Disease Control and Prevention website: https://www.cdc.gov/nchs/nhanes/.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data

NHANES data are available from the CDC on the National Center for Health Statistics website: https://www.cdc.gov/nchs/nhanes/.

Notes on contributors

Maryam Majidi is an MSc Student in Epidemiology in the School of Public Health and Safety of Shahid Beheshti University of Medical Science, Tehran, Iran.

Naghmeh Khadembashi works in the Department of English Language in the School of Allied Medical Sciences of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Koorosh Etemad (MD, MPH, PhD) is Assistant Professor of Epidemiology in the School of Public Health and Safety of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Mahdi Jafari (MD, MPH, PhD) is Assistant Professor of Health Psychology in the School of Medicine of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Soheila Khodakarim obtained her PhD in Biostatistics at Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2012, MS in Biostatistics at Shiraz University of Medical Sciences, Shiraz, Iran in 2007, and Bachelor's degree in statistics at Shiraz University, Shiraz, Iran in 2004. After completion of the doctoral study, Dr Khodakarim jointed the School of Public Health and Safety School of Allied Medical Sciences of Shahid Beheshti University of Medical Sciences. Her interest is modelling data by different methods such as Structural Equation Modelling, Path Analysis, and Survival Analysis. She is cooperating with International Journal of Cancer Management.