Associations Between Rumination and the Incidence of First‐Episode Major Depressive Disorder in a Sample of Chinese University Students: From a 1‐Year Longitudinal Study

Background As a core risk factor for major depressive disorder (MDD), rumination has been confirmed to predict the onset of MDD in adolescents significantly. However, its pathogenic effect on first‐episode MDD in university freshmen has not been systematically evaluated. This study aims to investigate the impact of rumination on the incidence of first‐episode MDD among university freshmen. Methods In this longitudinal cohort study, 6985 participants without MDD at baseline completed a follow‐up survey 1 year later. The Chinese version of the Composite International Diagnostic Interview 3.0 (CIDI‐3.0) was used to assess MDD. Rumination was measured by the Ruminative Responses Scale. Results The incidence of first‐episode MDD among Chinese freshmen was 2.26%. Symptomatic rumination was significantly associated with a 1‐year incidence of MDD (OR = 1.72, 95% CI: 1.33–2.23), controlling for the effects of baseline depressive symptoms and stressful life events. Limitations All the information collected in this survey was from the participants’ recall and selection, making recall and reporting biases possible. Conclusions Rumination increases the likelihood of first‐episode MDD among Chinese university freshmen. Therefore, mitigating or even avoiding rumination could be beneficial in reducing the risk of MDD among university freshmen.