Mauling of the "Celtic Tiger": clinical characteristics and outcome of first-episode depression secondary to the economic recession in Ireland.
BACKGROUND
There is a dearth of studies describing clinical characteristics and outcome of patients who present with mood disorders related to economic recession.


OBJECTIVE
To describe a cohort of patients admitted with first-episode depression related to the Irish economic recession and compare this cohort with all other first-episode depressives admitted during the same time period (2009-2010).


METHODS
A cohort of 137 patients admitted with first-episode depression to an independent university teaching hospital was prospectively identified and followed up from admission over 2 years (mean follow-up 430 days, s.d. 176 days). The cohort was divided into "Celtic Tiger" (patients with first-episode depression secondary to the economic recession) and non-Celtic Tiger control patients (other first-episode depressed patients). Both groups were compared in terms of clinical characteristics at baseline and outcome over follow-up.


RESULTS
The number of admissions due to first depressive episodes were higher in recession years 2009/10 than in pre-recession years 2008/9. Celtic Tiger patients were predominantly male and more severely depressed with more marked suicidal ideation (χ(2), p<0.001) than control patients. They were more likely to recover (χ(2), p=0.013), less likely to recur (χ(2), p<0.001) and had faster time to recovery (log rank, p<0.001) and slower time to full recurrence (log rank, p=0.001). The Celtic Tiger patients spent more time asymptomatic and less time at full and subthreshold depression levels over follow-up.


CONCLUSIONS
Study setting of centre specializing in affective disorders treatment, retrospective nature of follow-up after initial prospective interview and lack of patient follow-up interview.


CONCLUSIONS
The study describes a subgroup of patients with severe depression associated with economic recession with likely high suicide risk but very favourable outcome.
Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. Electronic address: thekisot@tcd.ie.
Thekiso B
TB
Thekiso
Department of Psychiatry, Trinity College Dublin, Dublin 2, Ireland. Electronic address: eaheron@tcd.ie.
Elizabeth A
EA
Heron
Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. Electronic address: barkatmassood@hotmail.com.
Barkat
B
Masood
Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. Electronic address: mmurphy@stpatsmail.com.
Matt
M
Murphy
Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. Electronic address: d.mcloughlin@tcd.ie.
Declan M
DM
McLoughlin
Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. Electronic address: nkennedy@stpatsmail.com.
Noel
N
Kennedy
D000328:Adult; D000368:Aged; D000818:Animals; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D057172:Economic Recession / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D059020:Suicidal Ideation
Depression; Economic recession; Psychiatric epidemiology; Suicide