Clinical and psychosocial factors associated with the outcome of unipolar major depression: a one year prospective study.
BACKGROUND
The role of psychosocial and clinical variables in the prediction of major depression is controversial. In a previous paper, we obtained a one-year predictive multivariate model of non-remission for major depression, based on the presence of a personality disorder, a low self-esteem and a low satisfaction with social support.


OBJECTIVE
To evaluate more in depth both personality disorders and psychosocial variables as predictors of outcome.


METHODS
A prospective study on 57 consecutive outpatients with major depressive episodes were followed-up monthly during one year. Clinical and psychosocial variables were registered, including personality (DSM-IV criteria and IPDE structured interview), previous quality of life, self-esteem, social support and dyadic adjustment. Remission was defined as a HDS score less than 8. Univariate and multivariate (logistic regression) analyses were applied.


RESULTS
68% of the patients reached remission at 12 months. Personality disorder (diagnosed clinically but not according to IPDE), and previous quality of life were the variables more consistently associated to remission at 12 months. Among follow-up variables, remission at 3 months was strongly associated with remission.


CONCLUSIONS
Our findings confirm the importance of the clinical diagnosis of personality disorder in the major depression outcome. However, more studies are needed to clarify the divergence between clinical and structured interview guided diagnosis. With the exception of quality of life, psychosocial variables had a weak and non consistent relationship with outcome.
Ezquiaga
Elena
E
Hospital Universitario La Princesa, Madrid 28006, Spain. eezquiaga@yahoo.com
García-López
Aurelio
A
de Dios
Consuelo
C
Leiva
Ana
A
Bravo
Marifé
M
Montejo
Julieta
J
D000328:Adult; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D010554:Personality Disorders / Q000150:complications* / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome