BACKGROUND Although lifestyle-based treatment approaches are recommended as important aspects of depression care, the quantitative influence of aggregated healthy lifestyles on depression recurrence and mortality remains unknown. OBJECTIVE To investigate the association between healthy lifestyle and the risks of first-time hospitalisation for recurrent depression and mortality. METHODS 26 164 adults with depression (mean (SD) age, 56.0 (7.9) years) were included from UK Biobank between 2006 and 2010 and followed up until 2022. Depression was defined as a physician's diagnosis in hospital admissions or the use of prescribed antidepressant medication. A weighted healthy lifestyle score (HLS) was calculated based on smoking, alcohol consumption, diet, sleep pattern, physical activity, social health, employment status and greenspace interaction. FINDINGS Over a 13.3-year follow-up, 9740 cases of first-time hospitalisation due to depression recurrence and 1527 deaths were documented. Compared with the lowest HLS tertile, the highest tertile was associated with a 27% lower risk (HR=0.73, 95% CI 0.69 to 0.77) of first-time hospitalisation for depression recurrence and a 22% (HR=0.78, 95% CI 0.68 to 0.91) lower risk of mortality among adults with depression. Lower risks of first-time hospitalisation for depression recurrence were observed among those who smoked less, drank more alcohol, followed healthier diets and sleep patterns, spent more time employed in current job or had greater exposure to greenspace. CONCLUSION AND IMPLICATIONS Greater adherence to healthy lifestyle was associated with a lower risk of hospitalisation and mortality among adults with pre-existing depression. Incorporating behaviour modification as an essential part of clinical practice for depressed patients could complement medication-based therapies.

中文翻译：

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健康的生活方式以及患有抑郁症的成年人需要住院治疗的抑郁症复发风险和死亡率：一项前瞻性队列研究。


背景虽然基于生活方式的治疗方法被推荐为抑郁症护理的重要方面，但总体健康生活方式对抑郁症复发和死亡率的定量影响仍然未知。目的 调查健康生活方式与首次住院复发性抑郁症和死亡风险之间的关联。方法 2006 年至 2010 年间，英国生物银行纳入了 26 164 名患有抑郁症的成年人（平均 (SD) 年龄为 56.0 (7.9) 岁），并随访至 2022 年。抑郁症的定义是医生在入院时诊断或使用处方抗抑郁药药物。根据吸烟、饮酒、饮食、睡眠模式、体力活动、社会健康、就业状况和绿地互动计算加权健康生活方式得分（HLS）。结果 在 13.3 年的随访中，记录了 9740 例因抑郁症复发首次住院的病例和 1527 例死亡病例。与最低 HLS 三分位数相比，最高三分位数与首次住院抑郁症复发风险降低 27%（HR=0.73，95% CI 0.69 至 0.77）相关，与首次住院抑郁症复发风险降低 22%（HR=0.78，95% CI 0.77）相关。 0.68 至 0.91）降低了患有抑郁症的成年人的死亡风险。那些吸烟较少、饮酒较多、遵循更健康饮食和睡眠模式、花更多时间从事当前工作或更多接触绿色空间的人，首次因抑郁症复发住院的风险较低。结论和意义 对于患有抑郁症的成年人来说，更加坚持健康的生活方式与较低的住院和死亡率风险相关。 将行为矫正作为抑郁症患者临床实践的重要组成部分可以补充基于药物的治疗。