First-Episode Major Depression

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Abstract
Background: There is a sex difference in the prevalence of unipolar major depression. This study sought to determine whether there is a sex difference in its course. Methods: The National Institute of Mental Health Collaborative Program on the Psychobiology of Depression—Clinical Studies provided data on 96 male and 101 female subjects who were diagnosed as having a first episode of unipolar major depressive disorder at intake and on whom prospective data were available. We looked for differences at intake in factors other than sex that might affect the course of illness: demographic factors, characteristic features of the first depressive episode, psychiatric history, and family history of depression. We then examined the course of depression of these subjects during the following 15 years. Results: The subjects were similar at intake, enabling us to focus on sex when we looked for differences in the course. Most subjects recovered from their first episode of major depression, but the majority had at least 1 recurrence in the following 5 years. During the following 15 years, male and female subjects did not differ significantly in the time to recovery, the overall time to first recurrence, or the number or severity of recurrences of major depressive episodes. There was no evidence for a more chronic course of depression in women. Conclusion: There were few significant sex differences in the course of major depressive disorder in this study population.