title: Factors associated with chronic depressive episodes: a preliminary report from the STAR-D project.
abstract: OBJECTIVE
  To identify baseline sociodemographic and clinical factors associated with a current chronic major depressive episode (MDE).
  
  
  METHODS
  Outpatients with major depressive disorder enrolled in 41 US primary or psychiatric care sites were divided into two groups based on self-report of current episode length (<24 or > or =24 months). Logistic regression models were used to identify factors associated with chronicity of current depressive episode.
  
  
  RESULTS
  About 21.2% of 1380 subjects were in current, chronic MDEs. Older age, less education, lower income, no private insurance, unemployment, greater general medical illness burden, lower physical quality of life, concurrent generalized anxiety disorder, fewer prior episodes, and history of prior suicide attempts were all associated with chronic episodes. Blacks, Hispanics, and patients receiving care in primary as opposed to psychiatric care settings exhibited greater chronicity.
  
  
  CONCLUSIONS
  Chronic depressive episodes are common and are associated with greater illness burden, comorbidity, socioeconomic disadvantage, and racial/ethnic minority status.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. w-gilmer@northwestern.edu
authors.forename: W S
authors.initials: WS
authors.lastname: Gilmer
authors.forename: M H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: A J
authors.initials: AJ
authors.lastname: Rush
authors.forename: S R
authors.initials: SR
authors.lastname: Wisniewski
authors.forename: J
authors.initials: J
authors.lastname: Luther
authors.forename: R H
authors.initials: RH
authors.lastname: Howland
authors.forename: D
authors.initials: D
authors.lastname: Yohanna
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.forename: J
authors.initials: J
authors.lastname: Alpert
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000523:psychology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010045:Outpatients; D011788:Quality of Life; D044469:Racial Groups; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class; D013406:Suicide, Attempted