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Background  The purpose of this study was to investigate the relationship between multiple chronic diseases and depressive symptoms in middle-aged and elderly populations.    Methods  This study was performed using the 2009 Korean Community Health Survey, which targeted adults over the age of 40 ( N  = 156,747 participants, 88,749 aged 40–59 years and 67,998 aged ≥60 years). The Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) was used as the measurement tool for depressive symptoms (CES-D-K score over 16). Multiple chronic diseases were defined as the concurrent presence of two or more chronic diseases.    Results  The prevalence and risk ratios (RRs) of experiencing depressive symptoms increased in the presence of multiple chronic diseases and with the number of comorbidities. The RRs of experiencing depressive symptoms according to the presence of multiple chronic diseases were higher in the middle-aged population (adjusted RR, 1.939, 95% confidence limits (CL), 1.82-2.06) than in the elderly population (adjusted RR, 1.620, 95% CL, 1.55-1.69). In particular, middle-aged women who suffer from 4 or more chronic diseases have the highest RR (adjusted RR, 4.985, 95% CL, 4.13-6.03) for depressive symptoms.    Conclusions  Multiple chronic diseases are closely associated with depressive symptoms in middle-aged and elderly populations. Given the mutual relationship between multiple chronic diseases and depressive symptoms, attention to and the assessment of depressive symptoms are needed in people with multiple chronic diseases.    Electronic supplementary material  The online version of this article (10.1186/s12889-017-4798-2) contains supplementary material, which is available to authorized users.

bmc public health

The relationship between multiple chronic diseases and depressive symptoms among middle-aged and elderly populations: results of a 2009 korean community health survey of 156,747 participants