Table 3.
Risk/Protective Factors Examined in Relation to Depressive Psychopathology, Ranked in Order of Strongest Risk Factor to Strongest Protective Factor
| Reference | Risk/Protective Factor | k | N | Pooled Effect Size | I2 | AMSTAR 2 Rating | GRADE Rating | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Metric | Estimate | 95% CI | p < .05 | eOR | |||||||
| Potential risk factors (eOR > 1.00) | |||||||||||
| Theorell et al., 2015 | Bullying in the workplace | 4 | 12,173 | OR | 2.82FE | (2.21, 3.59) | Yes | 2.82 | NR | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Smith et al., 2016 | Perfectionistic attitudes | 3 | 250 | r | 0.24RE | (0.11, 0.35) | Yes | 2.45 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Pedersen et al., 2022 | Parental depression | 3 | 1,700 | OR | 2.30RE | (0.73, 7.24) | No | 2.30 | 66% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Anglin et al., 2013 | Vitamin D deficiency | 3 | 8,815 | HR | 2.21RE | (1.40, 3.49) | Yes | 2.21 | 21% | ★★★☆ | ⊕ ⊕ ⊕ ◯ |
| Zhang et al., 2022 | Prenatal alcohol exposure | 2 | 5,731 | OR | 2.20FE | (1.19, 4.05) | Yes | 2.20 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Nielson et al., 2021 | Reduced reward-related positivity | 5 | 1,112 | r | 0.18RE | (0.04, 0.30) | Yes | 1.94 | 74% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Gong et al., 2022 | Maternal obesity | 2 | 1,108,865 | RR | 1.92FE | (1.72, 2.11) | Yes | 1.92 | 0% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Jeronimus et al., 2016 | Neuroticism | 16 | 49,585 | d | 0.33NR | (0.18, 0.52) | Yes | 1.82 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Madsen et al., 2017 | Job strain | 7 | 27,461 | OR | 1.77RE | (1.47, 2.13) | Yes | 1.77 | 24% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Schuch et al., 2016 | Low cardiorespiratory fitness | 3 | 1,131,330 | HR | 1.76RE | (1.61, 1.91) | Yes | 1.76 | 12% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Jadambaa et al., 2019 | Bullying victimization | 23 | NR | RR | 1.73FE | (1.46, 2.05) | Yes | 1.73 | 71% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Atlantis et al., 2013 | Chronic obstructive pulmonary disease | 6 | 7,439,159 | RR | 1.69RE | (1.45, 1.96) | Yes | 1.69 | 71% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Scott et al., 2021 | Any sleep disturbances | 9 | 11,524 | OR | 1.62RE | (1.43, 1.82) | Yes | 1.62 | 64% | ★★★☆ | ⊕ ◯ ◯ ◯ |
| Smith et al., 2016 | Doubts about actions | 6 | 914 | r | 0.13RE | (0.07, 0.19) | Yes | 1.61 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Smith et al., 2016 | Socially prescribed perfectionism | 9 | 1,402 | r | 0.13RE | (0.07, 0.18) | Yes | 1.61 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Rönnblad et al., 2019 | Job insecurity | 6 | 23,648 | OR | 1.61RE | (1.29, 2.00) | Yes | 1.61 | 44% | ★★☆☆ | ⊕ ⊕ ◯ ◯ |
| Pedersen et al., 2022 | Negative family environment | 8 | 6,192 | OR | 1.60RE | (0.82, 3.10) | No | 1.60 | 89% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Luppino et al., 2010 | Obesity | 6 | 7,866 | OR | 1.56RE | (1.02, 2.40) | Yes | 1.56 | 38% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Smith et al., 2016 | Self-criticism | 5 | 861 | r | 0.12RE | (0.07, 0.20) | Yes | 1.55 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Maternal postnatal depression | 3 | 10,379 | OR | 1.52RE | (0.92, 2.50) | No | 1.52 | 55% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Rugulies et al., 2017 | Effort-reward imbalance at work | 8 | 84,963 | OR | 1.49RE | (1.23, 1.80) | Yes | 1.49 | 59% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Gong et al., 2022 | Maternal hypertensive disorders | 2 | 12,709 | RR | 1.49FE | (1.11, 1.86) | Yes | 1.49 | 3% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Pan et al., 2012 | Metabolic syndrome | 10 | 26,936 | OR | 1.49RE | (1.19, 1.87) | Yes | 1.49 | 57% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Su et al., 2021 | Born to parents < 20 years old | 9 | 93,850 | OR | 1.46RE | (1.22, 1.74) | Yes | 1.46 | 32% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Low birth weight | 10 | 27,574 | OR | 1.44RE | (1.17, 1.76) | Yes | 1.44 | 62% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Smith et al., 2016 | Concern over mistakes | 9 | 1,402 | r | 0.10RE | (0.05 ,0.15) | Yes | 1.44 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Smith et al., 2016 | Personal standards | 6 | 809 | r | 0.10RE | (0.04, 0.17) | Yes | 1.44 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Huang, 2015a | Negative attributional style | 47 | 9,482 | β | 0.10RE | NR | NR | 1.44 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Nielson et al., 2021 | Reduced striatal reward processing | 9 | 1,692 | r | 0.10RE | (0.03, 0.18) | Yes | 1.44 | 5% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Angerer et al., 2017 | Nighttime shift work | 7 | 26,294 | RR | 1.42RE | (0.92, 2.19) | No | 1.42 | 74% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Esmaeelzadeh et al., 2018 | Alcohol use | 2 | 14,628 | OR | 1.39RE | (0.95, 2.03) | No | 1.39 | 89% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Bean et al., 2022 | Dampening of positive affect | 12 | 3,760 | β | 0.09RE | (0.05, 0.13) | Yes | 1.39 | 22% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Liao et al., 2022 | Peer victimization | 64 | NR | β | 0.09RE | (0.08, 0.11) | Yes | 1.39 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Preterm birth | 7 | 128,001 | OR | 1.38RE | (1.00, 1.90) | Yes | 1.38 | 62% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | < 9 years of maternal education | 9 | 41,768 | OR | 1.37RE | (1.19, 1.57) | Yes | 1.37 | 40% | ★★☆☆ | ⊕ ⊕ ◯ ◯ |
| Gobbi et al., 2019 | Cannabis use during adolescence | 7 | 11,606 | OR | 1.37RE | (1.16, 1.62) | Yes | 1.37 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Maternal prenatal depression | 8 | 36,985 | OR | 1.36RE | (1.07, 1.72) | Yes | 1.36 | 76% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Virtanen et al., 2018 | Long working hours | 13 | 43,887 | OR | 1.35RE | (1.07, 1.71) | Yes | 1.35 | NR | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Haynes et al., 2019 | Perceived overweight | 4 | 11,689 | OR | 1.35RE | (1.16, 1.58) | Yes | 1.35 | 25% | ★★★★ | ⊕ ⊕ ◯ ◯ |
| Smith et al., 2016 | Self-oriented perfectionism | 6 | 809 | r | 0.08RE | (0.01, 0.15) | Yes | 1.34 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Matison et al., 2021 | High Dietary Inflammatory Index | 3 | NR | OR | 1.33RE | (1.04, 1.70) | Yes | 1.33 | 43% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Hu et al., 2019 | Sugar-sweetened beverage consumption | 4 | 536,895 | RR | 1.30FE | (1.19, 1.41) | Yes | 1.30 | 0% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Pinquart, 2017 | Parental harsh control | 12 | NR | r | 0.07RE | (0.02, 0.13) | Yes | 1.29 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Rood et al., 2009 | Emotion-focused rumination | 9 | 2,387 | r | 0.07NR | (0.03, 0.11) | Yes | 1.29 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Low socioeconomic status | 6 | 28,710 | OR | 1.29RE | (1.10, 1.52) | Yes | 1.29 | 60% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Paternal smoking | 4 | 26,237 | OR | 1.28RE | (1.11, 1.48) | Yes | 1.28 | 33% | ★★☆☆ | ⊕ ⊕ ◯ ◯ |
| Mac Giollabhui et al., 2021 | Tumor necrosis factor α | 3 | 1,063 | r | 0.06RE | (0.00, 0.12) | Yes | 1.25 | 0% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Chaplin et al., 2021 | Smoking | 4 | 9,134 | OR | 1.23RE | (1.02, 1.49) | Yes | 1.23 | 11% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Pinquart, 2017 | Parental psychological control | 29 | NR | r | 0.05RE | (0.01, 0.09) | Yes | 1.20 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Pagliai et al., 2021 | High consumption of ultra-processed foods | 2 | 41,637 | RR | 1.20RE | (1.03, 1.40) | Yes | 1.20 | 42% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Mac Giollabhui et al., 2021 | Interleukin-6 | 7 | 7,807 | r | 0.05RE | (0.02, 0.07) | Yes | 1.19 | 10% | ★★★★ | ⊕ ⊕ ◯ ◯ |
| Huang et al., 2020 | Sedentary behavior | 8 | 80,565 | RR | 1.15RE | (1.05, 1.27) | Yes | 1.15 | 50% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Matison et al., 2021 | High adherence to a Western diet | 7 | 79,917 | OR | 1.15RE | (1.04, 1.26) | Yes | 1.15 | 46% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Luppino et al., 2010 | Overweight | 5 | 6,118 | OR | 1.14RE | (0.83, 1.55) | No | 1.14 | 14% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Richardson et al., 2015 | Poor neighborhood socioeconomic conditions | 10 | 6,835,959 | OR | 1.14RE | (1.01, 1.28) | Yes | 1.14 | 82% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Zhang et al., 2017 | Meat consumption | 3 | 20,072 | RR | 1.13FE | (1.03, 1.24) | Yes | 1.13 | 19% | ★☆☆☆ | ⊕ ⊕ ◯ ◯ |
| Su et al., 2021 | Born to parents > 35 years old | 6 | 73,208 | OR | 1.13RE | (1.07, 1.20) | Yes | 1.13 | 0% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Baranyi et al., 2021 | Neighborhood crime | 16 | 175,121 | r | 0.03RE | (0.01, 0.05) | Yes | 1.12 | NR | ★★★★ | ⊕ ◯ ◯ ◯ |
| Kim & von dem Knesebeck, 2016 | Unemployment | 11 | 60,258 | OR | 1.12RE | (1.08, 1.17) | Yes | 1.12 | 40% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Braithwaite et al., 2019 | Long-term PM2.5 exposure | 2 | 69,114 | OR | 1.11RE | (1.00, 1.23) | Yes | 1.11 | 20% | ★★★☆ | ⊕ ◯ ◯ ◯ |
| Kim et al., 2020 | Aspirin use | 7 | 1,944,481 | OR | 1.11RE | (1.08, 1.14) | Yes | 1.11 | 0% | ★☆☆☆ | ⊕ ⊕ ⊕ ◯ |
| Leung et al., 2022 | Prescription opioid use | 8 | 113,467 | OR | 1.10RE | (0.89, 1.36) | No | 1.10 | NR | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Molendijk et al., 2018 | High adherence to unhealthy food groups | 7 | 97,632 | OR | 1.09RE | (1.00, 1.19) | No | 1.09 | 26% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Maternal anxiety | 2 | 13,127 | OR | 1.09RE | (1.02, 1.17) | Yes | 1.09 | 0% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Maternal drinking | 2 | 13,976 | OR | 1.09RE | (0.96, 1.24) | No | 1.09 | 0% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Su et al., 2021 | Second or later in birth order | 5 | 21,246 | OR | 1.08RE | (0.91, 1.29) | No | 1.08 | 30% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Mac Giollabhui et al., 2021 | C-reactive protein | 15 | 40,627 | r | 0.02RE | (0.00, 0.03) | Yes | 1.07 | 40% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Molendijk et al., 2018 | High adherence to unhealthy dietary patterns | 10 | 84,870 | OR | 1.05RE | (0.99, 1.12) | No | 1.05 | 45% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Prieto-Fidalgo et al., 2022 | Observing facet of dispositional mindfulness | 15 | 1,161 | β | 0.01RE | NR | No | 1.04 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Potential protective factors (eOR < 1.00) | |||||||||||
| Matison et al., 2021 | High adherence to a “healthy” diet | 8 | 75,965 | OR | 0.97RE | (0.95, 1.00) | No | 0.97 | 30% | ★★★★ | ⊕ ⊕ ◯ ◯ |
| Prieto-Fidalgo et al., 2022 | Describing facet of dispositional mindfulness | 16 | 1,508 | β | −0.02RE | NR | No | 0.93 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Matison et al., 2021 | High adherence to a Mediterranean diet | 3 | 10,343 | OR | 0.93RE | (0.84, 1.04) | No | 0.93 | 81% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Matison et al., 2021 | High vegetable intake | 4 | 176,659 | OR | 0.91RE | (0.87, 0.96) | Yes | 0.91 | 0% | ★★★★ | ⊕ ⊕ ◯ ◯ |
| Molendijk et al., 2018 | High adherence to neutral food groups | 7 | 98,084 | OR | 0.91RE | (0.84, 1.00) | No | 0.91 | 43% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Rood et al., 2009 | Distraction response style | 4 | 1,063 | r | −0.03NR | (−0.09, 0.03) | No | 0.90 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Molendijk et al., 2018 | High adherence to healthy food groups | 18 | 147,011 | OR | 0.89RE | (0.83, 0.95) | Yes | 0.89 | 71% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Pinquart, 2017 | Parental behavioral control | 30 | NR | r | −0.04RE | (−0.09, 0.01) | No | 0.86 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Matison et al., 2021 | High fruit intake | 4 | 176,659 | OR | 0.85RE | (0.81, 0.90) | Yes | 0.85 | 0% | ★★★★ | ⊕ ⊕ ◯ ◯ |
| Dong et al., 2015 | Higher tea consumption | 5 | 9,000 | RR | 0.85RE | (0.72, 0.99) | Yes | 0.85 | 32% | ★☆☆☆ | ⊕ ⊕ ⊕ ◯ |
| Wang et al., 2016 | Caffeine consumption | 4 | 29,033 | RR | 0.84RE | (0.75, 0.93) | Yes | 0.84 | 0% | ★☆☆☆ | ⊕ ⊕ ⊕ ◯ |
| Huang, 2015b | Academic achievement | 27 | 12,982 | β | −0.06RE | (−0.10, −0.03) | Yes | 0.80 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Dishman et al., 2021 | Physical activity | 179 | NR | OR | 0.79RE | (0.75, 0.82) | Yes | 0.79 | 88% | ★★★☆ | ⊕ ◯ ◯ ◯ |
| Pinquart, 2017 | Parental warmth | 74 | NR | r | −0.07RE | (−0.10, −0.04) | Yes | 0.78 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Lassale et al., 2019 | High Healthy Eating Index score | 4 | 45,533 | OR | 0.76RE | (0.57, 1.02) | No | 0.76 | 81% | ★★☆☆ | ⊕ ◯ ◯ ◯ |
| Prieto-Fidalgo et al., 2022 | Acting with awareness facet of dispositional mindfulness | 8 | 8,747 | β | −0.08FE | NR | Yes | 0.75 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Khazanov & Ruscio, 2016 | Positive emotionality | 58 | 24,229 | β | −0.08RE | (−0.09, −0.06) | Yes | 0.75 | 28% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Ding & Zhang, 2022 | High dietary vitamin E intake | 2 | 14,777 | RR | 0.74FE | (0.41, 1.32) | No | 0.74 | 46% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Theorell et al., 2015 | Decision latitude at work | 18 | 61,867 | OR | 0.73FE | (0.68, 0.77) | Yes | 0.73 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Prieto-Fidalgo et al., 2022 | Non-judging facet of dispositional mindfulness | 16 | 1,508 | β | −0.09RE | NR | No | 0.72 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Phelan et al., 2018 | Adherence to a diet high in magnesium | 2 | 18,156 | OR | 0.71RE | (0.40, 1.02) | No | 0.71 | 4% | ★★★★ | ⊕ ◯ ◯ ◯ |
| Yosaee et al., 2022 | High zinc intake | 4 | 15,852 | RR | 0.66RE | (0.50, 0.82) | Yes | 0.66 | 14% | ★★★☆ | ⊕ ⊕ ◯ ◯ |
| Prieto-Fidalgo et al., 2022 | Non-reacting facet of dispositional mindfulness | 16 | 1,788 | β | −0.12RE | NR | Yes | 0.65 | NR | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Pinquart, 2017 | Parental autonomy granting | 10 | NR | r | −0.12RE | (−0.20, −0.03) | Yes | 0.65 | 0% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
| Sowislo & Orth, 2013 | Self-esteem | 77 | 35,501 | β | −0.16RE | (−0.18, −0.14) | Yes | 0.56 | 66% | ★☆☆☆ | ⊕ ◯ ◯ ◯ |
Note. CI = confidence interval; eOR = equivalent odds ratio; OR = odds ratio; RR = risk ratio; RE = random effects model; FE = fixed effects model; NR = not reported.
k represents the number of samples; N represents the number of participants; I2 represents heterogeneity. AMSTAR 2 rating indicates overall methodological quality of the review, where ★☆☆☆ = critically low, ★★☆☆ = low, ★★★☆ = moderate, and ★★★★ = high. GRADE rating indicates quality of evidence for the specific risk/protective factor, where ⊕ ◯ ◯ ◯ = very low, ⊕ ⊕ ◯ ◯ = low, ⊕ ⊕ ⊕ ◯ = moderate, and ⊕ ⊕ ⊕ ⊕ = high.