"Double depression": superimposition of acute depressive episodes on chronic depressive disorders

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Abstract
Although double depression, major depressive disorder superimposed on an underlying chronic depression, is a frequent phenomenon, the concept has not been well formulated clinically and has rarely been described in the research literature. It was found that 26% of 101 patients who met the criteria for major depressive disorder had an underlying chronic depressive disorder of at least 2 year''s duration; recovery rates for patients with superimposed depression differed greatly depending on whether recovery was defined as recovery from the major depressive disorder only or recovery from both disorders; and patients with superimposed depression relapsed at a significantly higher rate immediately after recovery from the acute episode of depression than did patients without superimposed depression.

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