The aetiological relationship between depressive symptoms and health-related quality of life: A population-based twin study in Sri Lanka

TY - JOUR

T1 - The aetiological relationship between depressive symptoms and health-related quality of life

T2 - A population-based twin study in Sri Lanka

AU - Triantafyllou, Panagiota

AU - Nas, Zeynep

AU - Zavos, Helena

AU - Sumathipala, Athula

AU - Jayaweera, Kaushayla

AU - Siribaddana, Sisira

AU - Hotopf, Matthew

AU - Ritchie, Stuart

AU - Rijsdijk, Fruhling

N1 - Funding Information: The Colombo Twin and Singleton study was funded in whole, or in part, by the Wellcome Trust [Grant number 093206/Z/10/Z], https:// wellcome.org. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. FR, AS, SS and MH were involved in the second CoTaSS study as co-applicants of a Welcome trust funded grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We are grateful to the participants of the Colombo Twin and Singleton Study for their participation in this research. Publisher Copyright: Copyright: © 2022 Triantafyllou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

PY - 2022/3

Y1 - 2022/3

N2 - ObjectiveDepression often co-occurs with poor health-related quality of life (HRQL). Twin studies report genetic and individual-level environmental underpinnings in the aetiology of both depression and HRQL, but there is limited twin research exploring this association further. There is also little evidence on sex differences and non-Western populations are underrepresented. In this paper we explored the phenotypic and aetiological relationship between depressive symptoms and HRQL and possible sex differences in a low-middle-income Sri Lankan population.MethodData for 3,948 participants came from the Colombo Twin and Singleton Follow-up Study (CoTaSS-2). Using self-report measures of depressive symptoms and HRQL, we conducted univariate and bivariate sex-limitation twin analyses.ResultsDepressive symptoms showed moderate genetic (33%) and strong nonshared environmental influences (67%). Nonshared environment accounted for the majority of variance in all the subscales of HRQL (ranging from 68 to 93%), alongside small genetic influences (ranging from 0 to 23%) and shared environmental influences (ranging from 0 to 28%). Genetic influences were significant for emotional wellbeing (23%). Shared environmental influences were significant for four out of the eight HRQL variables (ranging from 22–28%), and they were more prominent in females than males. Depressive symptoms were significantly associated with lower HRQL scores. These correlations were mostly explained by overlapping nonshared environmental effects. For traits related to emotional functioning, we also detected substantial overlapping genetic influences with depressive symptoms.ConclusionsOur study confirmed previous findings of a negative association between depressive symptoms and HRQL. However, some of the aetiological factors of HRQL differed from Western studies, particularly regarding the effects of shared environment. Our findings highlight the importance of cross-cultural research in understanding associations between psychological wellbeing and HRQL.

AB - ObjectiveDepression often co-occurs with poor health-related quality of life (HRQL). Twin studies report genetic and individual-level environmental underpinnings in the aetiology of both depression and HRQL, but there is limited twin research exploring this association further. There is also little evidence on sex differences and non-Western populations are underrepresented. In this paper we explored the phenotypic and aetiological relationship between depressive symptoms and HRQL and possible sex differences in a low-middle-income Sri Lankan population.MethodData for 3,948 participants came from the Colombo Twin and Singleton Follow-up Study (CoTaSS-2). Using self-report measures of depressive symptoms and HRQL, we conducted univariate and bivariate sex-limitation twin analyses.ResultsDepressive symptoms showed moderate genetic (33%) and strong nonshared environmental influences (67%). Nonshared environment accounted for the majority of variance in all the subscales of HRQL (ranging from 68 to 93%), alongside small genetic influences (ranging from 0 to 23%) and shared environmental influences (ranging from 0 to 28%). Genetic influences were significant for emotional wellbeing (23%). Shared environmental influences were significant for four out of the eight HRQL variables (ranging from 22–28%), and they were more prominent in females than males. Depressive symptoms were significantly associated with lower HRQL scores. These correlations were mostly explained by overlapping nonshared environmental effects. For traits related to emotional functioning, we also detected substantial overlapping genetic influences with depressive symptoms.ConclusionsOur study confirmed previous findings of a negative association between depressive symptoms and HRQL. However, some of the aetiological factors of HRQL differed from Western studies, particularly regarding the effects of shared environment. Our findings highlight the importance of cross-cultural research in understanding associations between psychological wellbeing and HRQL.

UR - http://www.scopus.com/inward/record.url?scp=85127295269&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0265421

DO - 10.1371/journal.pone.0265421

M3 - Article

SN - 1932-6203

VL - 17

JO - PLoS One

JF - PLoS One

IS - 3 March

M1 - e0265421

ER -