Prognostic factors in major depression: A long-term follow-up study of 323 patients

Background: Optimal long-term treatment of major depression should assess the background factors affecting remission and recurrent episodes. The duration and number of previous depressive episodes has been shown to be important for recurrence. This long-term prospective study of patients with major depression assessed the prognostic effect of variables related to childhood, social life and occupation. Methods: The study examined 323 patients in two follow-up examinations 12–25 years from the initial examination to the second follow-up. Stepwise logistic regression was used to evaluate the prognostic effect for depression at the second follow-up. Results: The risk of depression at the second follow-up was associated with several psychosocial factors in childhood, female gender, social isolation and a negative attitude towards one’s own occupation. Limitations: The patient group was selected from the practice of only one psychiatrist. Conclusions: Several psychosocial factors in childhood, female gender, social isolation and a negative attitude towards one’s own occupation have previously been shown to be associated with the risk of depression. The results in this study suggest that these factors are also important in predicting the outcome of a major depressive episode and the risk of recurrent episodes.