Study population The Coronary Artery Risk Development in Young Adults (CARDIA) study is a prospective cohort study investigating the development of and risk factors for cardiovascular disease [9]. Participants completed follow-up examinations every 2 to 5 years for 30 years and depressive symptoms were measured repeatedly from Year 10 (our study baseline) between 1995 and 2015. At each study, participants provided written informed consent, and study protocols were approved by institutional review boards at each study site.