SHORT-TERM OUTCOME OF MAJOR DEPRESSION .2. LIFE EVENTS, FAMILY DYSFUNCTION, AND FRIENDSHIP DIFFICULTIES AS PREDICTORS OF PERSISTENT DISORDER

Objective: To determine whether there is a pattern of social character istics that specifically predicts persistent major depression at 36 we eks follow-up. Method: Sixty-eight consecutive cases with a first-epis ode DSM-III-R diagnosis of major depression completed a life events an d friendship difficulties interview at presentation and again at 36 we eks. Results: Four factors were associated with persistent psychiatric disorder in general: lack of a maternal confiding relationship with c urrent partner, family dysfunction and poor friendships at presentatio n, and severely disappointing events between presentation and follow-u p. There was no association between these adverse experiences. No comb ination of long-term or recent life events or difficulties was, howeve r, specifically associated with persistent depression. Conclusion: Non social factors may need to be taken into account to specifically expla in the phenotypic persistence of major depressive disorder in first-ep isode nonrecovered cases within a year of presentation. Psychosocial i nterventions with first-degree relatives and current close friendships should be considered as a part of the treatment strategy for first-ep isode major depression.