title: Potential predictors of delay in initial treatment contact after the first onset of depression in Japan: a clinical sample study.
abstract: BACKGROUND
  A growing body of evidence shows that reducing the duration of untreated illness (DUI) correlates with improved clinical outcome and course of depression. However, the factors involved in delaying treatment contact after the first onset of lifetime depression are not fully understood. This cross-sectional study aims to identify the characteristics that may predict the delay in initial treatment contact after the first onset of lifetime depression by comparing the socio-demographics and clinical characteristics between those with longer and shorter DUI in a well-characterized Japanese clinical sample.
  
  
  METHODS
  Ninety-five patients with depression with longer (>12 months) and shorter DUI (≤12 months) at three Japanese outpatient clinics were studied. Subjects received a comprehensive evaluation, including semi-structured clinical interviews and assessment battery, and their clinical charts were reviewed.
  
  
  RESULTS
  Of the total sample, the median of DUI was 4 months (interquartile range (IQR) 25th-75th percentile, 2-13). We found that 72.6% of patients seek treatment contact within the first year of depression onset. Multivariate logistic regression analysis showed that longer DUI in patients was associated with marital status (never married). Further, the DSM-IV melancholic features approached significance.
  
  
  CONCLUSIONS
  Our findings suggest that most Japanese patients with depression are likely to seek treatment within 1 year of onset, and that marital status and melancholia may be potential predictors of the delay in the initial treatment contact after the first onset of lifetime depression.
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ; Department of Psychiatry, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
authors.forename: Yoshiyo
authors.initials: Y
authors.lastname: Oguchi
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ; Center for Clinical Research, Keio University School of Medicine, Tokyo, Japan ; Department of Psychiatry, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Nakagawa
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Sado
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Mitsuda
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Psychiatry, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kato
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ; Department of Psychiatry, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Takechi
authors.affiliation: Department of Psychiatry, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Hiyama
authors.affiliation: Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Mimura
keywords: Duration of untreated illness; Help-seeking; Major depressive disorder; Marital status