Factors associated with 1-year outcome of major depression in the community.
Evidence from outcome studies of major depression indicates a high rate of relapse and chronicity, and that prior chronicity, recurrent episodes, and the presence of psychosocial stressors are associated with a poor outcome. However, the generalizability of these findings is limited because most studies have focused on treated samples; thus, these studies may have been biased toward more chronic or severe illnesses. In prospectively surveying a large probability sample of the general population, the Epidemiologic Catchment Area program offers the opportunity to investigate prognosis without selection bias. In this study, the Epidemiologic Catchment Area subjects with a diagnosis of Major Depressive Disorder at first interview (n = 423) were categorized according to their diagnostic status 1 year later. The results confirmed a high rate of nonrecovery, with clinical features associated with a poor outcome that resembled those identified in previous clinical studies. Overall, clinical factors were more important prognostically than were sociodemographic characteristics. However, there was some evidence that a poorer outcome in older women may partially explain the greater female prevalence of depression in the community.
Sargeant
J K
JK
Department of Psychiatry, University of British Columbia, Vancouver, Canada.
Bruce
M L
ML
Florio
L P
LP
Weissman
M M
MM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008393:Marriage; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D012923:Social Class