Factors associated with recurrent depression: a prospective study in family practice.
BACKGROUND
Depression has a high rate of recurrence. Finding the variables that predict which patients are at higher risk of experiencing a recurrent episode of depression would benefit an individual patient.


OBJECTIVE
To determine the factors associated with recurrent depression >12 months.


METHODS
Consecutive patients (N = 1094), aged 18-75 years, were recruited from 23 family practices across Estonia. The patients were followed up at 6- and 12-month intervals as suggested in the PredictD study. Depression was assessed using the Composite International Diagnostic Interview. Each participant filled in a questionnaire to assess their risk factors for depression.


RESULTS
Major depression was diagnosed in 13% of the patients. Twenty-eight per cent of the depressed patients had a recurrent episode of depression 12 months later. The odds of having recurrent depression were significantly higher for patients who had a history of drug abuse, odds ratio (OR) 7.48 [95% confidence interval (CI) = 1.42-39.43), for patients who had experienced discrimination, OR 2.92 (95% CI = 1.05-8.11) and for patients with a history of childhood abuse, OR 1.58 (95% CI = 1.05-2.38).


CONCLUSIONS
One-third of the patients developed recurrent depression. Drug abuse, discrimination and childhood abuse predicted recurrent depression. These factors should be taken into consideration by family doctors when managing patients with depression.
Suija
Kadri
K
Department of Family Medicine, University of Tartu, Puusepa 1a-2120, Tartu, Estonia. kadri.suija@ut.ee
Aluoja
Anu
A
Kalda
Ruth
R
Maaroos
Heidi-Ingrid
HI
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D000368:Aged; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D055030:Drug Users / Q000523:psychology; D004957:Estonia; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult