Long-term outcome of episodes of major depression. Clinical and public health significance

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Abstract
Of patients with an episode of major depressive disorder and no history of chronic minor depression who sought treatment at 5 university medical centers 21% (20/97) had not recovered after 2 yr of prospective follow-up. The rate of recovery was highest in the 3 mo. after nentry into the study, with a notable decrease in rate after 1 yr. Most patients who did not recover had severe depressive symptoms throughout the 2 yr of follow-up. Long duration of episode before entry into the study, inpatient hospitalization status at entry, intact marriage, low family income, admitting research center and a history of nonaffective pyschiatric disorders (including alcoholism) predicted a chronic course. The implications of these findings for clinicians, researchers, and public health planners are discussed.

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