Housing type and risk of depression - the mediating effects of perceived indoor annoyances and loneliness: a Danish cohort study, 2000-2018

BACKGROUND: Few studies have found that housing types and tenure might be associated with decreased mental health. Therefore, the aim was to investigate the association between housing type and the development of incident depression. Furthermore, quantifying the mediated effects through perceived indoor annoyances and perceived loneliness for the association between housing type and depression.

METHODS: In this cohort study, we followed 14,387 individuals. Data on depression, housing type, perceived indoor annoyances, perceived loneliness and several covariates were obtained from the Danish National Patient Register, the Danish National Prescription Registry, the Building and Housing Register, and the Danish Health and Morbidity Survey. The association between housing type and depression was estimated by using a generalised linear model with Poisson distribution of the number of incident depressions and a logarithmic transformation of risk time as offset. Causal mediation analysis estimated the total effect mediated by perceived indoor annoyances and perceived loneliness.

RESULTS: Individuals living in owned terrace houses, rented terrace houses, and rented apartments had a significantly higher incidence rate (IR) of depression compared to individuals in owner-occupied detached houses. Living in a rented apartment compared to owning a detached house was associated with an adjusted IRR for depression of 1.32 (95% CI 1.14, 1.53). Of this association, 11% could be attributed to perceived indoor annoyances and 8% to perceived loneliness. For individuals living in rented terrace houses compared to owner-occupied detached houses, perceived indoor annoyances mediated 6% of the association between housing type and depression.

CONCLUSION: Individuals living in certain housing types had a significantly higher IR of depression compared to individuals in owner-occupied detached houses. Our findings suggest that some of the excessed depression incidents among individuals living in rented apartments and rented terrace houses compared to detached houses could be attributed to differences in the number of perceived indoor annoyances and perceived loneliness. However, future studies are needed to confirm the findings of the present study and address other pathways and possible causations.