Determinants of persistence of major depressive episodes in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).
BACKGROUND
Data on determinants of persistence of major depressive episodes (MDE) are inconsistent due to methodological shortcomings of the studies involved.


OBJECTIVE
To examine determinants of persistence of MDE in subjects from the general population (N=250) with new episodes of DSM-III-R major depression.


METHODS
The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiologic survey in the adult population (N=7076), using the Composite International Diagnostic Interview (CIDI). A broad range of potential determinants was assessed.


RESULTS
Determinants of persistence were severity of the index episode, longer duration of previous episodes, (chronic) physical illness and lack of social support. A recurrent episode predicted shorter duration.


CONCLUSIONS
Follow-up was only 2 years and duration of episode was retrospectively assessed.


CONCLUSIONS
Just as in clinical populations, illness-related factors seem to be the strongest predictors of persistence of MDE. A thorough assessment of each depressed patient on the predictors of persistence is advisable.
Spijker
Jan
J
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. JSpijker@trimbos.nl
de Graaf
Ron
R
Bijl
Rob V
RV
Beekman
Aartjan T F
AT
Ormel
Johan
J
Nolen
Willem A
WA
D000293:Adolescent; D000328:Adult; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support