Cabello, MariaMiret, MartaCaballero, Francisco FelixChatterji, SomnathNaidoo, NirmalaKowal, PaulD'Este, CatherineAyuso-Mateos, Jose Luis2021-10-042021-10-041744-8603http://hdl.handle.net/1885/250435Background: Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. However, few longitudinal evidence of these relationships has been collected in emerging countries. The present study aims i) to analyse whether people with unhealthy lifestyles are more likely to develop depression, and ii) to examine whether depressed people with unhealthy lifestyles are more likely to remain depressed. A total of 7908 participants from Ghana, India, Mexico and Russia were firstly evaluated in the World Health Organization's Study on Global AGEing and Adult Health (SAGE) Wave 0 (2002-2004) and re-evaluated in 2007-2010 (Wave 1). Data on tobacco use, alcohol drinking and physical activity, were collected. Logistic regressions models were employed to assess whether baseline unhealthy lifestyles were related to depression in Wave 1, among people without 12-month depression in Wave 0 and any previous lifetime diagnosis of depression, and to 12-month depression at both study waves (persistent depression). Results: Baseline daily and non-daily smoking was associated with depression in Wave 1. Low physical activity and heavy alcohol drinking were associated with persistent depression. Conclusions: Unhealthy lifestyles and depression are also positively related in emerging countries. Smoking on a daily and non-daily basis was longitudinally related to depression. Depressed people with low physical activity and with heavy drinking patterns were more likely to become depressed over time. Several interpretations of these results are given. Further studies should check whether a reduction of these unhealthy lifestyles leads to lower depression rates and/or to a better clinical prognosis of depressed people.This paper uses data from the WHO's Study on Global AGEing and Adult Health (SAGE). SAGE is supported by the US National Institute on Aging through Interagency Agreements (OGHA 04034785; YA1323-08-CN-0020; Y1- AG-1005-01) and through a research grant (R01-AG034479). The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme FP7/2007 – 2013 under grant agreement n° 316795 (MARATONE project). The present work was also supported by the Centro de Investigacion Biomédica en Red en Salud Mental (CIBERSAM) and by the Instituto de Salud Carlos III - FIS research grant PI13/00059, which has been co-funded by the European Union European Regional Development Fund (ERDF) "A Way to Build Europe". This study was also supported by the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 305968 (EMERALD project).application/pdfen-AU© The Author(s). 2017https://creativecommons.org/licenses/by/4.0/DepressionLongitudinal studyMiddle-income countriesLifestyles201710.1186/s12992-017-0237-52020-11-23Creative Commons License (Attribution 4.0 International)