Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-21T04:38:22.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of 1-year outcomes of major depressive disorder among individuals with a lifetime diagnosis: a population-based study

Published online by Cambridge University Press:  11 July 2011

J. L. Wang ,
S. B. Patten ,
S. Currie ,
J. Sareen  and
N. Schmitz
J. L. Wang*
Affiliation:
Departments of Psychiatry and Community Health Sciences, Faculty of Medicine, University of Calgary, Canada
S. B. Patten
Affiliation:
Departments of Psychiatry and Community Health Sciences, Faculty of Medicine, University of Calgary, Canada
S. Currie
Affiliation:
Mental Health Information and Evaluation Unit, Alberta Health Services, Calgary, Canada
J. Sareen
Affiliation:
Departments of Psychiatry, Psychology and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada
N. Schmitz
Affiliation:
Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
*
*Address for correspondence: J. L. Wang, Ph.D., Rm 4D69, TRW Building, 3280 Hospital Dr. NW, Calgary, AB, CanadaT2N 4Z6. (Email: jlwang@ucalgary.ca)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Examining predictors of the outcomes of major depressive disorder (MDD) is important for clinical practice and population health. There are few population-based longitudinal studies on this topic. The objectives of this study were to (1) estimate the proportions of persistent and recurrent MDD among those with MDD over 1 year, and (2) identify demographic, socio-economic, workplace psychosocial and clinical factors associated with the outcomes.

Method

From a population-based longitudinal study of the working population, participants with a lifetime diagnosis of MDD were selected (n=834). They were classified into two groups: those with and those without current MDD. The proportions of 1-year persistence and recurrence of MDD were estimated. MDD was assessed by the World Health Organization (WHO) Composite International Diagnostic Interview, CIDI-Auto 2.1, by telephone.

Results

The proportions of persistent and recurrent MDD in 1 year were 38.5% [95% confidence interval (CI) 31.1–46.5] and 13.3% (95% CI 10.2–17.1) respectively. Long working hours, negative thinking and having co-morbid social phobia were predictive of persistence of MDD. Perceived work–family conflict, the severity of a major depressive episode and symptoms of depressed mood were significantly associated with the recurrence of MDD.

Conclusions

Clinical and psychosocial factors are important in the prognosis of MDD. The factors associated with persistence and recurrence of MDD may be different. More large longitudinal studies on this topic are needed so that clinicians may predict potential outcomes based on the clinical profile and provide interventions accordingly. They may also take clinical action to change relevant psychosocial factors to minimize the chance of persistence and/or recurrence of MDD.

Keywords

Longitudinal studymajor depressive disorderoutcome predictorspopulation-basedwork environmental factors
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 2 , February 2012 , pp. 327 - 334
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Beesdo, K, Bittner, A, Pine, DS, Stein, MB, Hofler, M, Lieb, R, Wittchen, HU (2007). Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry 64, 903–912.Google Scholar
Blackmore, E, Stansfeld, S, Weller, I, Munce, S, Zagorski, B, Stewart, D (2007). Major depressive episodes and work stress: results from a national population survey. American Journal of Public Health 97, 2088–2093.CrossRefGoogle ScholarPubMed
Broadhead, WE, Blazer, DG, George, LK, Tse, CK (1990). Depression, disability days, and days lost from work in a prospective epidemiologic survey. Journal of the American Medical Association 264, 2524–2528.Google Scholar
Chandola, T, Martikainen, P, Bartley, M, Lahelma, E, Marmot, M, Michikazu, S, Nasermoaddeli, A, Kagamimori, S (2004). Does conflict between home and work explain the effect of multiple roles on mental health? A comparative study of Finland, Japan, and the UK. International Journal of Epidemiology 33, 884–893.CrossRefGoogle ScholarPubMed
Frone, MR (2000). Work-family conflict and employee psychiatric disorders: the National Comorbidity Survey. Journal of Applied Psychology 85, 888–895.Google Scholar
Karasek, R, Brisson, C, Kawakami, N, Houtman, I, Bongers, P, Amick, B (1998). The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology 3, 322–355.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003 a). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 3095–3105.CrossRefGoogle ScholarPubMed
Kessler, RC, Merikangas, KR, Berglund, P, Eaton, WW, Koretz, DS, Walters, EE (2003 b). Mild disorders should not be eliminated from the DSM-V. Archives of General Psychiatry 60, 1117–1122.CrossRefGoogle Scholar
Kroenke, K, Spitzer, RL, Williams, JB (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606–613.CrossRefGoogle ScholarPubMed
Patten, SB (2008). Major depression prevalence is very high, but the syndrome is a poor proxy for community populations' clinical treatment needs. Canadian Journal of Psychiatry 53, 411–419.Google Scholar
Patten, SB, Wang, JL, Williams, JV, Currie, S, Beck, CA, Maxwell, CJ, El-Guebaly, N (2006). Descriptive epidemiology of major depression in Canada. Canadian Journal of Psychiatry 51, 84–90.Google Scholar
Patten, SB, Wang, JL, Williams, JV, Lavorato, DH, Khaled, SM, Bulloch, AG (2010). Predictors of the longitudinal course of major depression in a Canadian population sample. Canadian Journal of Psychiatry 55, 669–676.Google Scholar
Sargeant, JK, Bruce, ML, Florio, LP, Weissman, MM (1990). Factors associated with 1-year outcome of major depression in the community. Archives of General Psychiatry 47, 519–526.Google Scholar
Siegrist, J, Starke, D, Chandola, T, Godin, I, Marmot, M, Niedhammer, I, Peter, R (2004). The measurement of effort-reward imbalance at work: European comparisons. Social Science and Medicine 58, 1483–1499.CrossRefGoogle ScholarPubMed
Skodol, AE, Grilo, CM, Keyes, KM, Geier, T, Grant, BF, Hasin, DS (2011). Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample. American Journal of Psychiatry 168, 257–264.CrossRefGoogle Scholar
Spijker, J, Bijl, RV, de Graaf, R, Nolen, WA (2001). Determinants of poor 1-year outcome of DSM-III-R major depression in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatrica Scandinavica 103, 122–130.CrossRefGoogle ScholarPubMed
StataCorp (2010). STATA Statistical Software: Release 10.0. Stata Corporation: College Station, TX.Google Scholar
Statistics Canada (2010). Canadian Community Health Survey – Mental Health and Well-Being.Google Scholar
Stein, MB, Fuetsch, M, Muller, N, Hofler, M, Lieb, R, Wittchen, HU (2001). Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Archives of General Psychiatry 58, 251–256.CrossRefGoogle ScholarPubMed
Ustun, TB, Kessler, RC (2002). Global burden of depressive disorders: the issue of duration. British Journal of Psychiatry 181, 181–183.CrossRefGoogle ScholarPubMed
Wang, JL (2004 a). A longitudinal population-based study of treated and untreated major depression. Medical Care 42, 543–550.Google Scholar
Wang, JL (2004 b). Perceived work stress and major depressive episode(s) in a population of employed Canadians over 18 years old. Journal of Nervous and Mental Disease 192, 160–163.Google Scholar
Wang, JL (2005). Work stress as a risk factor for major depressive episode(s). Psychological Medicine 35, 865–871.Google Scholar
Wang, JL (2006). Perceived work stress, imbalance between work and family/personal lives, and mental disorders. Social Psychiatry and Psychiatric Epidemiology 41, 541–548.Google Scholar
Wang, JL, Affifi, T, Cox, B, Sareen, J (2007). The relationship between work-home imbalance and mental disorders: findings from the U.S. National Comorbidity Survey. American Journal of Industrial Medicine 50, 143–149.Google Scholar
Wang, JL, Lesage, A, Schmitz, N, Drapeau, A (2008). The relationship between work stress and mental disorders in men and women: findings from a population-based study. Journal of Epidemiology and Community Health 62, 42–47.CrossRefGoogle ScholarPubMed
Wang, JL, Schmitz, N, Dewa, C, Stansfeld, S (2009). Changes in perceived job strain and the risk of major depression: results from a population-based longitudinal study. American Journal of Epidemiology 169, 1085–1091.CrossRefGoogle ScholarPubMed
Wang, JL, Schmitz, N, Smailes, E, Sareen, J, Patten, S (2010 a). Workplace characteristics, depression, and health-related presenteeism in a general population sample. Journal of Occupational and Environmental Medicine 52, 836–842.CrossRefGoogle Scholar
Wang, JL, Smailes, E, Sareen, J, Fick, GH, Schmitz, N, Patten, SB (2010 b). The prevalence of mental disorders in the working population over the period of global economic crisis. Canadian Journal of Psychiatry 55, 598–605.CrossRefGoogle ScholarPubMed
WHO (2011). Composite International Diagnostic Interview (CIDI) Auto 2.1. World Health Organization Collaborative Training Center: Australia.Google Scholar