title: Prognosis of depressive disorders in the general population- results from the longitudinal Finnish Health 2011 Study.
abstract: BACKGROUND
  Depressive disorders are among the most pressing public health challenges worldwide. Yet, not enough is known about their long-term outcomes. This study examines the course and predictors of different outcomes of depressive disorders in an eleven-year follow-up of a general population sample.
  
  
  METHODS
  In a nationally representative sample of Finns aged 30 and over (BRIF8901), major depressive disorder (MDD) and dysthymia were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000. The participants were followed up in 2011 (n=5733). Outcome measures were diagnostic status, mortality, depressive symptoms and health-related quality of life. Multiple imputation (MI) was used to account for nonresponse.
  
  
  RESULTS
  At follow-up, 33.8% of persons with baseline MDD and 42.6% with baseline dysthymia received a diagnosis of depressive, anxiety or alcohol use disorder. Baseline severity of disorder, measured by the Beck Depression Inventory, predicted both persistence of depressive disorder and increased mortality risk. In addition, being never-married, separated or widowed predicted persistence of depressive disorders, whereas somatic and psychiatric comorbidity, childhood adversities and lower social capital did not. Those who received no psychiatric diagnosis at follow-up still had residual symptoms and lower quality of life.
  
  
  CONCLUSIONS
  We only had one follow-up point at eleven years, and did not collect information on the subjects' health during the follow-up period.
  
  
  CONCLUSIONS
  Depressive disorders in the general population are associated with multiple negative outcomes. Severity of index episode is the strongest predictor of negative outcomes. More emphasis should be placed on addressing the long-term consequences of depression.
authors.affiliation: National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland. Electronic address: niina.markkula@helsinki.fi.
authors.forename: Niina
authors.initials: N
authors.lastname: Markkula
authors.affiliation: National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Helsinki, Finland.
authors.forename: Tommi
authors.initials: T
authors.lastname: Härkänen
authors.affiliation: Statistics Finland, Helsinki, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Nieminen
authors.affiliation: National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Helsinki, Finland.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Peña
authors.affiliation: Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland.
authors.forename: Aino K
authors.initials: AK
authors.lastname: Mattila
authors.affiliation: National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.affiliation: Turku University Hospital and the University of Turku, Turku, Finland.
authors.forename: Samuli I
authors.initials: SI
authors.lastname: Saarni
authors.affiliation: National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Suvisaari
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010698:Phobic Disorders / Q000453:epidemiology; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*
keywords: Depressive disorders; Dysthymia; General population; Major depressive disorder; Outcomes; Prognosis