PSYCHOSOCIAL AND PHYSICAL CORRELATES OF CHRONIC DEPRESSION

This study used a case-control design to address differences in psycho social, physical and clinical profiles between subjects who presented with a chronic index episode of major depression and those who present ed with a non-chronic index episode. Subjects were adult patients part icipating in the Duke University Mental Health Clinical Research Cente r (MHCRC) for the Study of Depression in Later Life. Gases (N = 88) wh o reported duration of depressive symptoms lasting greater than or equ al to 24 months at enrollment were compared to controls (N = 354) who reported symptoms lasting 1-12 months. The groups were compared with r espect to selected demographic and clinical variables, physical functi on deficits, medical comorbidity, social support constructs and number of recent stressful life events. Social support and physical health w ere more relevant to chronicity of major depressive illness than were severity of illness or family history. Older age (> 60 years) intensif ied the deleterious effect of recent negative life events and reduced the deleterious effect of functional impairment on chronic major depre ssion. These findings require special emphasis where treatment for chr onic major depression is divorced from considerations of the social en vironment and functional capacity. (C) 1997 Elsevier Science Ireland L td.