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medRxiv PreprintsInternational31 October 2026

The relation of a blood DNA methylation score with six-year depression course and risk factors

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Background: DNA methylation (DNAm) signatures of major depressive disorder (MDD) may be related to psychosocial, environmental, biological, and lifestyle risks. We tested a blood-based DNAm depression score (MD-MS) based on an existing EWAS (N = 24,754) in N = 731 individuals for predicting 8 clinical and 16 MDD risk factors and whether different MDD trajectories mapped to changes in MD-MS over six years. Methods: We calculated the MD-MS based on the top 15 strongest, epigenome-wide significant depression associated sites from the largest EWAS to date in EPICv2-profiled blood samples from N =
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