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Title: Previous disorders and depression outcomes in individuals with 12-month major depressive disorder in the World Mental Health surveys
Authors: Roest, Annelieke M
de Vries, Ymkje Anna
Al-Hamzawi, Ali
Alonso, Jordi
Ayinde, Olatunde O
Bruffaerts, Ronny
Bunting, Brendan
Caldas de Almeida, José Miguel
de Girolamo, Giovanni
Degenhardt, Louisa
Florescu, Silvia
Gureje, Oye
Haro, Josep Maria
Hu, Chiyi
Karam, Elie G.
Kiejna, Andrzej
Kovess-Masfety, Viviane
Lee, Sing
McGrath, John J
Medina-Mora, Maria Elena
Navarro-Mateu, Fernando
Nishi, Daisuke
Piazza, Marina
Posada-Villa, José
Scott, Kate M
Stagnaro, Juan Carlos
Stein, Dan J
Torres, Yolanda
Viana, Maria Carmen
Zarkov, Zahari
Kessler, Ronald C
de Jonge, Peter
Affiliations: Faculty of Medicine 
Keywords: Comorbidity
Major depressive disorder
Suicidal thoughts and behaviours
Issue Date: 2021
Part of: Epidemiology Psychiatric Sciences
Volume: 30
Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes.

Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning.

Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4–1.6) and suicidality (OR = 1.5–2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD.

These results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.
ISSN: 20457960
DOI: 10.1017/S2045796021000573
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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