| Depression is associated with increased morbidity and mortality and is highly prevalent, particularly in women. Studies indicate increased risk for onset of new and recurrent episodes of major depression in women during midlife. To improve understanding of the etiology of depression in midlife women and to inform prevention and treatment efforts, the risk and protective factors that influence the occurrence and course of depression in midlife women should be determined. In particular, the role of family history of depression in the development of depression among midlife women is unknown. This dissertation explores associations between family history and major depression in midlife women in the context of other risk and protective factors.;First, the relationship between family history and major depression was examined in 303 midlife women. Results showed that family history of depression is a significant predictor of midlife major depression, particularly in women with a history of depression prior to midlife.;Second, data from the same cohort of midlife women showed that family history of depression is associated with midlife major depression, after controlling for the menopausal transition and relevant time-varying covariates. Furthermore, menopausal status is associated with major depression among midlife women without a family history of depression but not among those with a family history.;Third, potential mediators of the relationship between family history and the onset of major depression during midlife were explored in 103 midlife women with a lifetime history of depression. Mediation analyses provided evidence that childhood abuse, trait anxiety, and life events mediate the effect of family history on the onset of depression during midlife.;In conclusion, family history of depression continues to play an important role in the development of depression in women during midlife, particularly for women with a prior history of depression. The public health relevance of our findings is that clinicians may be able to improve the emotional health of midlife women by assessing family history and lifetime history of depression to identify those at risk and by closely monitoring mood among women found to have such histories, thus allowing for implementation of appropriate interventions in a timely manner. |
