Risk factors for chronic depression - A systematic review

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany.
Journal of Affective Disorders (Impact Factor: 3.38). 03/2011; 129(1-3):1-13. DOI: 10.1016/j.jad.2010.03.025
Source: PubMed


One of five patients with an acute depressive episode develops chronic depression. Risk factors for a current depressive episode to become chronic are insufficiently known. This review was conducted to examine which factors represent a risk factor for the development of chronic depression for patients diagnosed with a depressive episode.
Medline, Psycinfo, ISI Web of Science, CINHAL and BIOSIS Previews were searched up until September 2007, complemented by handsearching in the December 1987 to December 2007 issues of Journal of Affective Disorders and investigating reference lists of included articles and existing reviews. On the basis of a formal checklist, two investigators independently decided which studies to include or exclude.
25 relevant primary studies with a total of 5192 participants were included in the systematic review. Overall the methodological quality of the included studies was found to be sufficient. Data synthesis was performed via vote counting. The following risk factors were identified: younger age at onset, longer duration of depressive episode, and family history of mood disorders. Psychological comorbidity i.e. anxiety disorders, personality disorders and substance abuse, low level of social integration, negative social interaction and lower severity of depressive symptoms repeatedly appeared concurrently with chronic depression.
Most included studies were cross-sectional thus drawing causal conclusions with regard to risk factors proved to be difficult.
Risk factors for a current depressive episode to become chronic were identified. To date only few significant longitudinal studies on this topic are available.

Download full-text


Available from: Levente Kriston, Sep 28, 2014
121 Reads
  • Source
    • "Finally, ORs of coping strategies for interpersonal stress, as a risk factor for depression might be relatively smaller, compared to other characteristics identified as risk factors for depression, such as younger age, longer duration of depressive episode, and a family history of mood disorders (for a review, see Hölzel et al. 2011 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Reassessing coping, a concept first proposed in Asia, refers to efforts to wait patiently for an appropriate opportunity to act or for a change or improvement in a situation, and can be observed in individuals facing stressful relationship events. The main purpose of the present study was to determine if reassessing coping would be associated with a lower risk of depression. The author examined the relationships between depression risk using the Center for Epidemiologic Studies Depression Scale (CES-D) and coping strategies for interpersonal stressors, including reassessing coping, in a sample of 1,912 Japanese college students. In our sample, the proportions of women and men with depressive symptoms were 55.28% (95% confidence intervals (CIs) [52.35, 58.20]) and 46.08% (95% CIs [42.63, 49.52]), respectively, using the conventional CES-D cut-off score of 16. A multivariate logistic regression analysis revealed that reassessing coping was significantly associated with a lower risk of depression (OR = 0.92, 95% CIs [0.89, 0.95]), after adjusting for gender. Distancing coping (strategies to actively damage, disrupt, or dissolve a stressful relationship) and constructive coping (strategies to improve, maintain, or sustain a relationship without irritating others) were significantly associated with a greater depression risk. Reassessing coping for interpersonal stressors was associated with a low risk of depression among Japanese college students.
    SpringerPlus 07/2015; 4(1):319. DOI:10.1186/s40064-015-1111-7
  • Source
    • "In the working population, depression can play an extremely important role in increasing sickness absence and work disability (Henderson et al., 2011; Kessler et al., 2006). Risk factors for depression include biological, demographic, and psychosocial factors (Holzel et al., 2011). Psychosocial work characteristics as risk factors for depression or depressive symptoms have been studied extensively in the work environment (Bonde, 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to quantify the association between weekend work and depressive symptoms in a representative sample of Korean employees. Subjects were 29 171 employees of companies in Korea. Data were obtained as part of the 2011 Korean Working Conditions Survey. Depressive symptoms were measured as a score of ≤7 on the World Health Organization Well-being Index. The association between weekend work and depressive symptoms was quantified using logistic regression, controlling for sociodemographic and work-related factors including the number of hours worked per week and stratified by gender. The prevalence of depressive symptoms was higher in employees who reported working at least one weekend day in the past month than in employees who reported working no weekend days in the past month. After controlling for confounders, including the number of hours worked per week, 1–4 days of weekend work in the past month (odds ratio [95% confidence interval] of 1.36 [1.18–1.57] in males and 1.32 [1.12–1.58] in females) and >4 days of weekend work in the past month (odds ratio [95% confidence interval] of 1.45 [1.19–1.78] in males and 1.36 [1.07–1.73] in females) were significantly associated with depressive symptoms. Weekend work was related with a significant increase in the prevalence of depressive symptoms in Korean workers.
    Chronobiology International 10/2014; 32(2). DOI:10.3109/07420528.2014.965826 · 3.34 Impact Factor
  • Source
    • "family history of mood disorders, younger age of onset, longer duration of depressive episode) and treatment/service characteristics (e.g. underdetection, undertreatment, limited treatment effectiveness) (Holzel et al., 2011; Cantrell et al., 2006). In addition, there is emerging evidence that patients' beliefs and experiences about MDD treatment (e.g. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: More than 50% of all major depressive disorder (MDD) patients experience insufficient improvement from the available treatment options. There is emerging evidence that patients' beliefs and experiences about MDD treatment influence treatment outcomes. The aim was to explore patients' perspectives on impeding characteristics of professional treatment for the recovery of MDD. Methods: In-depth interviews in a purposive sample with 27 recovered MDD patients who had received professional treatment. Data were qualitatively analyzed using constant comparison. Results: Participants' accounts yielded four major impeding themes: lack of clarity and consensus about the nature of the participants' MDD and the content of their treatment; precarious relationship with the clinician; unavailability of mental health care; and insufficient involvement of significant others. Limitations: The external generalizability may be limited due to missed other subgroups within depression. Conclusions: This study identified a comprehensive overview of impeding characteristics in MDD treatment from patients' perspectives. This may help clinicians to understand how patients experience MDD treatment, and to incorporate patients' perspectives about treatment into their joint decision-making. This can lead towards increased treatment adherence, motivation and finally success.
    Journal of Affective Disorders 06/2014; 167C:153-159. DOI:10.1016/j.jad.2014.05.065 · 3.38 Impact Factor
Show more