Prevalence and predictors of recurrence of major depressive disorder in the adult population.

De Gelderse Roos, Institute for Mental Health Care, Ede, The Netherlands.
Acta Psychiatrica Scandinavica (Impact Factor: 4.86). 12/2009; 122(3):184-91. DOI: 10.1111/j.1600-0447.2009.01519.x
Source: PubMed

ABSTRACT Knowledge of the risk of recurrence after recovery of a major depressive disorder (MDD) is of clinical and scientific importance. The purpose of this paper was to provide a systematic review of the prevalence and predictors of recurrence of MDD.
Studies were searched in Medline en PsychINFO using the search terms 'recur*', 'relaps*', 'depress*', 'predict*' and course.
Recurrence of MDD in specialised mental healthcare settings is high (60% after 5 years, 67% after 10 years and 85% after 15 years) and seems lower in the general population (35% after 15 years). Number of previous episodes and subclinical residual symptoms appear to be the most important predictors. Gender, civil status and socioeconomic status seem not related to the recurrence of MDD.
Clinical factors seem the most important predictors of recurrence. Data from studies performed in the general population and primary care on the recurrent course of MDD are scarce.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea. A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of 'over mild depression' in a follow-up survey. The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73-37.22]). In contrast, job stress from a 'difficult physical environment' revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04-0.92]). Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.
    Annals of occupational and environmental medicine. 01/2015; 27:1.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study hypothesized that the well-being of community residents in remission from major depression disorder (MDD) would not be significantly different from those without MDD. Data from the Midlife in the United States Survey (MIDUS), a prospective general population survey conducted in 1995 and 2004, were analysed. A comparison of the psychological well-being scores, Big Five personality scores and life satisfaction scores of remitted and non-remitted respondents revealed generally small effect size differences. The remitted group were more likely than the non-remitted group to have had past-year panic disorder at follow-up. In general, these results suggest that the well-being of respondents in MDD remission was relatively high.
    International Journal of Mental Health Promotion. 09/2012; 14(4):186-195.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: By 2020, depression is projected to be among the most important contributors to the global burden of disease. A plethora of data confirms that despite the availability of effective therapies, major depressive disorder continues to exact an enormous toll; this, in part, is due to difficulties reaching complete remission, as well as the specific associated costs of both the disorder's morbidity and mortality. The negative effects of depression include those on patients' occupational functioning, including absenteeism, presenteeism, and reduced opportunities for educational and work success. The use of management algorithms has been shown to improve treatment outcomes in major depressive disorder and may be less costly than "usual care" practices. Nevertheless, many patients with depression remain untreated. As well, even those who are treated often continue to experience suboptimal quality of life. As such, the treatment algorithms in this article may improve outcomes for patients suffering with depression. This paper introduces some of the principal reasons underlying these treatment gaps and examines measures or recommendations that might be changed or strengthened in future practice guidelines to bridge them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 12/2014; 220S1:S3-S14. · 2.68 Impact Factor