Journal Article

Protocol of a prospective community-based study about the onset and course of depression in a nationally representative cohort of adults in China: the China Depression Cohort Study-I

Li, Zongchang, Phillips, Michael R., Zhou, Jiansong, Li, Xuting, Tian, Yusheng, Xiao, Shuiyuan, Li, Lingjiang, Liu, Jun, Zhang, Xiaojie, Wang, Xiaoping

2023

Overview

Background Depression is the second most important cause of disability worldwide. Reducing this major burden on global health requires a better understanding of the etiology, risk factors, and course of the disorder. With the goal of improving the prevention, recognition, and appropriate management of depressive disorders in China, the China Depression Cohort Study will establish a nationally representative sample of at least 85,000 adults (the China Depression Cohort Study-I) and 15,000 middle school students (the China Depression Cohort Study-II) and follow them over time to identify factors that influence the onset, characteristics, and course of depressive disorders. This protocol describes the China Depression Cohort Study-I. Methods A multistage stratified random sampling method will be used to identify a nationally representative community-based cohort of at least 85,000 adults (i.e., ≥ 18 years of age) from 34 communities in 17 of mainland China’s 31 provincial-level administrative regions. Baseline data collection includes 1) demographic, social and clinical data, 2) diagnostic information, 3) biological samples (i.e., blood, urine, hair), 4) brain MRI scans, and 5) environmental data (e.g., community-level metrics of climate change, air pollution, and socio-economic characteristics). Baseline findings will identify participants with or without depressive disorders. Annual reassessments will monitor potential risk factors for depression and identify incident cases of depression. Cox Proportional-Hazards Regression, Network analysis, Disease trajectory modelling, and Machine learning prediction models will be used to analyze the collected data. The study’s main outcomes are the occurrence of depressive disorders; secondary outcomes include adverse behaviors (e.g., self-harm, suicide), the recurrence of depression and the incidence other mental disorders. Discussion The China Depression Cohort Study-I will collect a comprehensive, nationally representative set of individual-level and community-level variables over time. The findings will reframe the understanding of depression from a ‘biology-psychology-society’ perspective. This perspective will improve psychiatrists’ understanding of depression and, thus, promote the development of more effective subgroup-specific antidepressant drugs and other interventions based on the new biomarkers and relationships identified in the study. Trail registration The protocol has been registered on the Chinese Clinical Trial Registry (No. ChiCTR2200059016).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adults / Age / Air pollution / Analysis / Antidepressants / Biobanks / Biological properties / Biological samples / Biomarkers / Biostatistics / Care and treatment / Child & adolescent mental health / China / Climate change / Cohort analysis / Cohort study / Community / Community-based / Data collection / Data entry / Depression / Depression, Mental / Development and progression / Diagnosis / Disease / Dosage and administration / Drug development / Environmental Health / Epidemiology / Global health / Global temperature changes / Hazard identification / Health surveillance / Inflammation / Junior high school students / Longitudinal studies / Machine learning / Magnetic resonance imaging / Medicine / Medicine & Public Health / Mental depression / Mental disorders / Mental health / Methods / Network analysis / Prediction models / Prospective / Provinces / Public Health / Random sampling / Risk factors / Sampling methods / Self-injury / Statistical sampling / Study Protocol / Subgroups / Suicide / Teenagers / Trajectory analysis / Vaccine / World health