Risk factors and outcome predictors in the long-term depression

Abstract

Outcome studies indicate that some baseline sociodemographic variables are predictors of the chronic evolution of depressive disorders: gender, onset and existence of family psychiatric history, among others, much more controversial. Neuroimage studies have generally shown positive associations between the existence of structural changes and an adverse prognosis of depression, towards an evolution to chronicity or onset of a demential syndrome. Other major types of factors have been revised as well. One group related with the course of the disease: number of episodes and persistence of symptoms. Another group of factors gathers those related with clinical characteristics: presence or absence of determined symptoms or groups of symptoms. Finally, a third clinical factor of great relevance is comorbidity, both somatic and psychiatric. Problems in the recognition and diagnosis of depression and the use of unsuitable or inadequate therapeutic tools are still too frequent. Besides, treatment noncompliance is still a crucial problem for the long-term treatment of depression.