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The prevalence of recovered and new cases of depressionin relation to social support and temperament in an 11-year follow-up; The HUNT study
Nord-Trøndelag University College, Norway.
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0002-1614-7379
Sykehuset, Namsos, Norway.
Sykehuset Levanger, Norway.
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(English)Article in journal (Refereed) Submitted
Abstract [en]


This study aimed to describe changes in the prevalence of depression in relation to

social support and temperament, in an 11-year follow-up study.


Lack of social support is a risk factor for depression. Understanding the role of

temperament and social support in relation to development of, and recovery from, depression

may help nurses to intervene early with high-risk patients in order to prevent depression and

promote health.


Longitudinal design was used.


In total, 26,709 men (42.8%) and women (57.2%) aged 20-89 years from Nord-

Trøndelag County in Norway participated. Those who had a valid rating on the depression

subscale of the Hospital Anxiety and Depression Scale (HADS) from The Nord-Trøndelag

Health Study (HUNT) wave 2 (1995-97) and wave 3 (2006-08), including a complete

response to the Eysenck Personality Questionnaire (EPQ) and questions regarding social

support, were included.


The prevalence of new cases of depression was higher than the prevalence of

recovery from depression. There was a significant association between the sub-groups of

depression and temperament, changes in health, and social support. The risk factors for new

cases had a greater causal influence on depression than risk factors for recovery.


Prevention of depression seems to be more effective than treatment. Older

people and males are the most frequent new cases. Nurses should emphasize the interpersonal

process to meet the needs of an individual patient and his or her social network that provides

social support, especially among older people and males.

Keywords [en]
depression, nursing, social support, temperament
National Category
Medical and Health Sciences
URN: urn:nbn:se:miun:diva-18718OAI: oai:DiVA.org:miun-18718DiVA, id: diva2:615218
Available from: 2013-04-09 Created: 2013-04-09 Last updated: 2014-08-28Bibliographically approved
In thesis
1. The relationship between social support, personality and depression in the general population: Focusing on older people
Open this publication in new window or tab >>The relationship between social support, personality and depression in the general population: Focusing on older people
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today's wide variety of diseases and health problems are

influenced in part by an aging population and by environmental and

lifestyle changes. Depression is one of the most quickly growing

disorders, causing a huge decrease in quality of life. Depression also

increases with age. The expected increase in the number of older

people in the years to come might lead to an increasing problem of

increased case loads for primary health care in the coming years as

the delivery of healthcare services shifts from clinical settings to the

home. People who lack social support are more likely to experience

poorer quality of life, including depression. Personality is a robust

predictor of behaviour and essential life outcomes. The aim of this

thesis is to describe the relationship between social support,

personality and depression in the general population, with a focus on

older people.

This thesis used data from the Nord-Trondelag Health Study

(HUNT), a large census population survey in Norway. Paper I (n=

40,659), II (n= 35,832), and III (n=35,797) used data from HUNT3

(2006-2008), and Paper IV (n=25,626) used data from both HUNT2

(1995-1997) and HUNT3. Paper I, II, and III used cross-sectional

designs and paper IV used a longitudinal design. The age of the

sample was 20−89, divided into three age-groups: 20−64 years

(adults), 65−74 years (old), and 75−89 years (oldest old). Depression

was measured with the Hospital Anxiety and Depression Scale

(HADS in the HUNT2 and 3), personality was measured with a short

version of the Eysenck Personality Questionnaire (EPQ in the

HUNT3), and social support was examined with single questions

about perceived support from friends (HUNT2 and 3).


The main finding in Paper I was that self-rated perceived support

was significantly associated with depression, even after controlling

for age and gender, emotional support (OR = 3.14), and tangible

support (OR = 2.93). The effects of emotional and tangible support

differ between genders. Interaction effects were found for age groups

as well as emotional and tangible support. Paper II showed a

relationship between depression and both neuroticism and

extraversion in a general population. Older people are more likely to

score low on extraversion (E) than younger people. Interactions were

observed between neuroticism and age, neuroticism and gender, and

extraversion with depression. The interaction terms indicates a high

score on neuroticism (N) is enhanced by introversion, older age, and

being a male with depression. Paper III showed a significant

association between levels of perceived social support, personality,

sense of community in the neighbourhood, and civic participation.

Women frequently reported higher levels of social support, and

higher scores on both extraversion and neuroticism than men, while

men reported higher sense of community in the neighbourhood and

levels of civic participation than women. Paper IV showed that risk

factors had a greater effect on new cases than on recovery from

depression. The greatest association with new cases of depression

was found for male sex, the oldest age group, melancholics, those

who lacked social support, those who never participated in social

activities, those with decreasing community in the neighbourhood,

those with poor health, and those who have gotten divorced. The

greatest association with recovery from depression was found for

female sex, sanguine temperament, those with social support, those

who participated in social activities, those with increasing


community in the neighbourhood, and those who have obtained

better health.

The findings show that both social support and personality are

risk factors for developing depression. Nurses should put extra effort

into how they care for patients with low extraversion, high

neuroticism and, low social support in order to help these patients

avoid depression. Nurses have to "see the patient" and "care about",

and respect patient’s values, preferences and expressed needs.

Abstract [no]

Dagens panorama av sykdom og helseproblemer er tildels knyttet

til en aldrende befolkning og endringer i miljo og livsstil. Depresjon

er en av de lidelsene som oker betraktelig i befolkningen og som

forer med seg et stort tap av livskvalitet. Depresjon oker ogsa med

alderen. Okningen i antall eldre og malet om at fremtidens

helsetjenester i storre grad skal leveres i hjemmet, kan medfore okt

arbeidsmengde spesielt for primarhelsetjenesten. Mennesker som

mangler sosial stotte opplever i storre grad enn andre en darligere

livskvalitet, inkludert depresjon. Personlighet er en bestemmende

faktor for menneskers atferd og liv. Malet med denne avhandlingen

var a beskrive forholdet mellom sosial stotte, personlighet og

depresjon i den generelle befolkningen med fokus pa eldre


Denne avhandlingen benyttet data fra Helseundersokelsen i Nord-

Trondelag (HUNT). Artikkel I (n=40 659), II (n=35 626) og III (n=35

797) brukte data fra HUNT3 (2006-2008) og artikkel IV (n=25 626)

brukte data fra bade HUNT2 (1995-1997) og HUNT3. Artikkel I, II og

III har tverrsnittsdesign og artikkel IV har tidsdesign. Utvalgets alder

var fra 20-89 ar. I studiene ble utvalget inndelt i tre aldersgrupper:

20-64 ar (voksne), 65-74 ar (eldre) og 75-89 ar (eldste eldre).

Depresjon ble malt med Hospital Anxiety and Depression Scale

(HADS) (HUNT2 og 3), personlighet ble malt med en kortversjon av

Eysenck Personality Questionnaire (EPQ) (HUNT3) og sosial stotte

ble undersokt ved hjelp av enkeltsporsmal relatert til opplevd stotte

fra venner (HUNT2 og 3).

Hovedfunnet i artikkel I var at den selvrapporterte opplevelsen av

stotte hadde sammenheng med depresjon, selv etter at det var


kontrollert for alder og kjonn. Mens den emosjonelle stotten hadde

en oddsratio (OR) pa 3.14, hadde den praktiske stotten en OR pa

2.93. Effekten av emosjonell stotte og praktisk stotte varierte med

kjonn. Det ble funnet samspilleffekter for aldersgrupper, emosjonell

stotte og praktisk stotte. Artikkel II avdekket en sammenheng

mellom depresjon, nevrotisisme og ekstroversjon. Eldre mennesker

skaret oftere lavt pa ekstroversjon enn yngre mennesker.

Samspilleffekter ble funnet mellom nevrotisisme og kjonn,

nevrotisisme og alder og mellom nevrotisisme og ekstroversjon.

Disse samspilleffektene indikerte at en hoy skar pa nevrotisisme ble

forsterket av ekstraversjon, hoy alder og av a vare mann med

depresjon. I artikkel III ble det funnet en sammenheng mellom nivaer

av opplevd sosial stotte, personlighet, folelse av fellesskap i nabolag

og deltakelse i sosiale aktiviteter. Kvinnene skaret oftere pa et hoyer

niva av sosial stotte og de skaret hoyere pa bade ekstroversjon og

nevrotisisme enn menn. Menn skaret hoyere enn kvinner pa a ha en

folelse av fellesskap i nabolaget og de deltok oftere i sosiale

aktiviteter. I artikkel IV ble det funnet at risikofaktorer hadde en

storre effekt pa nye tilfeller av depresjon enn pa tilfriskning av

depresjon. De storste sammenhengene til nye tilfeller av depresjon

ble funnet i det a vare mann, vare i den eldste aldersgruppen, ha et

melankolsk temperament, mangle sosial stotte og oppleve en

synkende folelse av fellesskap i nabolag. Den storste sammenhengen

til tilfriskning av depresjon ble funnet i det a vare kvinne, ha et

sangvinsk temperament, ha sosial stotte, deltakelse i sosiale

aktiviteter, opplevelse av okende folelse av fellesskap i nabolaget og

oppleve bedring i sin helse.

Funnene viste at bade sosial stotte og personlighet er

risikofaktorer for a utvikle depresjon. Med tanke pa a hjelpe


pasienter til a unnga a utvikle depresjon bor sykepleiere utvise en

ekstra innsats i omsorgen for eldre pasienter som har lav

ekstroversjon, hoy nevrotisisme og lav sosial stotte. Med respekt for

pasientens verdier, onsker og uttrykte behov, blir det viktig for

sykepleiere a "se pasienten" og "bry seg om".

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University, 2013. p. 66
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 148
Depression, home nursing care, older people, personality, Depresjon, eldre, hjemmesykepleie, personlighet, sosial
National Category
Medical and Health Sciences
urn:nbn:se:miun:diva-18715 (URN)978-91-87103-71-1 (ISBN)
Public defence
2013-04-26, Juvika, Högskolan i Nord-Tröndelag, Namsos, 10:00 (Norwegian)
Available from: 2013-04-15 Created: 2013-04-08 Last updated: 2013-06-13Bibliographically approved

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