There are several factors that put people at risk for major depressive disorder (MDD). Among them are difficulties during childhood and genetic predisposition. It has been proven that people who experience a major depressive episode (MDE) are likely to have more than one occurrence, especially if certain risk factors are present. Although there has been some research exploring the rate of recurrence in clinical samples, few studies have looked at the rate of recurrence of MDEs in the general population. Because MDD is a lifelong condition that can be exacerbated by environmental and biological factors, it is important to know which factors put people with MDD at the greatest risk for another episode.
F. Hardeveld of the Institute for Mental Health Care in the Netherlands sought to accomplish this by assessing 687 individuals who had recovered from their last MDE more than six months prior. These individuals all had a lifetime diagnosis of MDD but were not currently experiencing an episode. They were evaluated at baseline and were followed over a period of three years. Hardeveld looked risk factors that included age of onset of first episode, number and severity of previous occurrences, difficult childhood, and adult experiences and neuroticism. The participants in this study had varying numbers of prior episodes and varying lengths of time since their last episode. This was especially critical to the results because by using this data, the results were able to capture recurrence rates over a 20-year span.
The analysis revealed that the longer the participants were in remission, the higher their chances of having another MDE. Specifically, those five years in remission were 13.2% at risk of relapse, those 10 years in remission had a 23.2% chance of relapse, and the participants who had gone 10 years with no MDE were at a 42% greater risk of another episode. Factors that increased the likelihood of another MDE were severe previous episode, difficult childhood experiences, neuroticism, young age at time of relapse, and younger age at time of initial MDD onset. Aside from these factors, biological and family risk factors, which were not investigated in this study, could contribute greatly to relapse rates. But, Hardeveld believes certain risk factors revealed in this study are significant. “The link between ongoing difficulties, which could cause (chronic) stress, and negative youth experiences, which were also a predictor of recurrence, is of particular interest,” said Hardeveld. Future work should address this in combination with genetic risk factors to get a more comprehensive understanding of which individuals are most at risk for MDD relapse in the future.
Hardeveld, F., et al. Recurrence of major depressive disorder and its predictors in the general population: Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Psychological Medicine 43.1 (2013): 39-48.ProQuest Research Library. Web. 30 Jan. 2013.
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