Determinants of poor 1-year outcome of DSM-III-R major depression in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Objective: To investigate risk factors of poor 1-year outcome of major depression in the general population and to compare the results with data from clinical populations. Method: Psychiatric diagnoses were determined in a representative sample (N = 7076) of the Dutch general population, using the Composite International Diagnostic Interview (CIDI) at baseline and 12 months later. A broad range of potential risk factors were evaluated. Results: Of the depressed people at baseline, 28.3% were depressed 12 months later. Younger age, severity of depression, longer duration of previous episodes, the presence of anhedonia and early awakening, external locus of control and multiple negative life events appear to be risk factors. Conclusion: Poor outcome of major depression is frequent in the general population. Largely the same risk factors are involved as in clinical populations.