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International audience; Background: The role of alcohol, tobacco and cannabis use in social differences in terms of depression is poorly understood.Method: We have applied mediation and moderated-mediation models stratified by gender to a population-based sample (N = 37,192) of French men and women from the Constances cohort with baseline and follow-up measures of depressive states. We have examined whether socioeconomic status (SES, measured by education and income) differences in the prevalence of depressive states may be explained by both differences in prevalence of substance use according to SES (mediating effects) and differential effects of substance use on depressive state according to SES (moderating effects).Results: In the mediation models, substance use only explained 5.3% and 2.4% of the association between low education and depressive state in men and women respectively, and was not a significant mediator for income. Moderated mediation models showed robust moderation effects of education and income in both men and women. The association of tobacco use with depressive symptoms, which was the only substance for which a mediation effect remained and for which the moderation effect of SES was the strongest, was significantly higher in participants with low SES.Limitations: The partially cross-sectional nature of the data restricts the possibility of drawing causality with regards to associations between SES and substance use.Conclusion: Targeting substance use, particularly tobacco, can especially reduce depression risk in individuals of low SES.

Événement(s) lié(s) : - Biobehavioral Science and Health Événement(s) lié(s) : - Biobehavioral Science and Health; Background: Alexithymia is a personality construct defined by difficulties in identifying and labelling one’s own emotional state. Although it has been suggested to be associated with cardiovascular diseases and mortality, studies are scarce and a causal relationship is questionable. For instance, no study examined the association of alexithymia with the incidence of cardiovascular diseases among a nonclinical population. The aim of this study was to explore this prospective association in participants without cardiovascular history at baseline. Methods: The 26-item Toronto Alexithymia Scale (TAS-26) was completed by 5,586 participants of the French Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) cohort (41.4 % of men, mean age ± SD: 52.2 ± 6.3 years). All participants were free from cardiovascular history at baseline. Covariates measured at baseline were age, occupational status, depressive symptoms, smoking status, body mass index, hypertension, diabetes, hypercholesterolemia and hypertriglyceridemia. The cardiovascular events were recorded using self-reported information or clinical visits, and were validated by an independent expert committee. Associations between alexithymia as well as covariates at baseline and cardiovascular events at follow-upwere estimated with hazard ratios (HR) and 95% confidence intervals (CI) computed in Cox regressions. Results: A total of 173 first cardiovascular events were recorded and validated during an average of 11.4 years of followup. After an initial adjustment for age and occupational status, the association between baseline alexithymia and cardiovascular events at follow-up was not significant among men (HR [95% CI] 1.00 [0.99-1.02]) or among women (HR [95% CI] 1.00 [0.97-1.03]). Similar results were found after further adjustment for all covariates. Likewise, exploratory analyses based on TAS-26 subscores showed no association. Conclusion: In this large prospective study, alexithymia and incident cardiovascular events were not associated among a nonclinical population. Greater CV mortality previously associated with alexithymia might result from poorer outcome in individuals with CV diseases rather than from increased incidence. The association between alexithymia and CV diseases in cross-sectional studies might result from the psychological impact of CV diseases

A growing body of studies suggests that the association between psychological factors and cardiometabolic risk might depend upon individual's socio-economic status.Data of Centre d'Investigations Préventives et Cliniques, Paris Prospective Study 3 and CONSTANCES cohort were used to examine the moderating role of occupational status (OS) on the associations between stress or depression and cardiometabolic risk markers.OS was a moderating factor of the association between perceived stress and high blood pressure among women (study No. 1), diabetes(study No. 2) and subclinical atherosclerosis (study No. 3), with increased risk for the individuals of lower OS. Similar pattern of results were observed for the association between depression and 10-year coronary heart disease risk among men (study No. 4).These results highlight the importance to systematically take into account the moderating effect of occupational inequalities when examining the association between psychological factors and cardiometabolic risk in epidemiological studies to better characterize this risk but also in public health policies and clinical practice for a better prevention.; Un nombre croissant d’études suggèrent que le rôle des facteurs psychologiques dans le risque cardio-métabolique pourrait différer selon la position socio-économique des individus.Les travaux de cette thèse ont utilisé les données du Centre d'Investigations Préventives et Cliniques, de l'Etude Prospective Parisienne 3 et de la cohorte CONSTANCES pour examiner le rôle modérateur de la profession et catégorie socioprofessionnelle (PCS) sur les relations entre stress ou dépression et différents marqueurs du risque cardio-métabolique.Les résultats montrent que la PCS était un facteur modérateur de l'association du stress perçu avec la PA élevée chez les femmes (étude no 1), le diabète (étude no 2) et l'athérosclérose préclinique (étude no 3), de telle sorte que les individus des PCS les moins favorisées étaient les plus à risque. Cela semblait également être le cas pour l'association entre la dépression et le risque de maladie coronarienne à 10 ans chez les hommes (étude no 4).Ces résultats montrent l'importance de prendre systématiquement en compte le rôle modérateur des inégalités socioprofessionnelles dans la relation entre facteurs psychologiques et risque cardio-métabolique, aussi bien dans les études épidémiologiques pour mieux caractériser ce risque, qu’en santé publique et pratique clinique pour mieux le prévenir.