Rate and predictors of persistent Major Depressive Disorder in a nationally representative sample

Objective: This study examined predictors of persistent major depressive disorder (MDD) over 10 years, focusing on the effects of clinical variables, physical health, and social support. Method: The National Survey of Midlife Development in the United States (MIDUS) in 1995-1996 and the follow-up in 2004-2006 were analyzed. Respondents were non-institutionalized English-speaking adults. Individuals who met clinical-based criteria for Major Depressive Disorder (MDD) at Time 1 were included in the analysis. Logistic regression was used with the baseline variables to predict non-recovery from MDD at follow-up. Results: Fifteen percent of the total sample was classified as having MDD in 1995-1996. Of those with MDD at baseline, 37% were also classified as having MDD in 2004-2006. Baseline variables that were associated with persistent MDD at follow-up were being female (OR=2.51; 95% CI: 1.28-4.92), having a comorbid anxiety disorder (OR=5.79; CI:2.29-14.62), having two or more chronic medical conditions (OR=2.61; 95% CI: 1.16-5.89), experiencing activity limitation (OR=2.45; CI: 1.96-4.41), and less contact with family (OR=2.41; CI: 1.40-4.27). Conclusion: A significant proportion of individuals experience persistent MDD after 10 years. Treatment strategies focused on physical health, social, and mental health needs are necessary to comprehensively address the factors that contribute to persistent MDD.