CLINICAL CHARACTERISTICS OF OUTPATIENTS WITH CHRONIC MAJOR DEPRESSION

A cross-sectional evaluation of 243 unipolar, nonpsychotic outpatients with major depression was conducted. All subjects were diagnosed by R DC with SADS-L structured interviews. Diagnoses included RDC primary/s econdary, RDC endogenous/nonendogenous and Winokur's family-history su btypes. Symptom severity was assessed by the 17-item Hamilton Rating S cale for Depression. Chronic depression was defined as the current epi sode of major depression lasting at least 2 years, corresponding to DS M-III-R and -IV criteria. Patients with chronic depression (n = 64) we re compared with those with nonchronic depression (n = 179). Chronicit y was not related to gender, symptom severity, prior length of illness , age at onset of illness, RDC endogenaus/nonendogenous, RDC primary/s econdary or Winokur's family-history subtypes. Those with chronic depr ession were older and had fewer major depressive episodes than the non chronic group. That the chronic group had fewer total episodes of depr ession than the nonchronic group, but a similar age at onset, is consi stent with the notion that patients in a current chronic episode have characteristically longer depressive episodes throughout the course of their illness. Those with chronic episodes may be subject to psycholo gical, biological and/or sociocultural factors that preclude an earlie r episode remission for these individuals.