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. 2021 Nov 11:30:e70.
doi: 10.1017/S2045796021000573.

Previous disorders and depression outcomes in individuals with 12-month major depressive disorder in the World Mental Health surveys

Annelieke M Roest  1 , Ymkje Anna de Vries  1 , Ali Al-Hamzawi  2 , Jordi Alonso  3   4   5 , Olatunde O Ayinde  6 , Ronny Bruffaerts  7 , Brendan Bunting  8 , José Miguel Caldas de Almeida  9 , Giovanni de Girolamo  10 , Louisa Degenhardt  11 , Silvia Florescu  12 , Oye Gureje  13 , Josep Maria Haro  14 , Chiyi Hu  15 , Elie G Karam  16   17   18 , Andrzej Kiejna  19   20 , Viviane Kovess-Masfety  21 , Sing Lee  22 , John J McGrath  23   24   25 , Maria Elena Medina-Mora  26 , Fernando Navarro-Mateu  27 , Daisuke Nishi  28 , Marina Piazza  29   30 , José Posada-Villa  31 , Kate M Scott  32 , Juan Carlos Stagnaro  33 , Dan J Stein  34 , Yolanda Torres  35 , Maria Carmen Viana  36 , Zahari Zarkov  37 , Ronald C Kessler  38 , Peter de Jonge  1 ; WHO World Mental Health Survey collaborators
Affiliations

Previous disorders and depression outcomes in individuals with 12-month major depressive disorder in the World Mental Health surveys

Annelieke M Roest et al. Epidemiol Psychiatr Sci. .

Abstract

Aims: Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes.

Methods: Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning.

Results: Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4-1.6) and suicidality (OR = 1.5-2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD.

Conclusions: These results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.

Keywords: Comorbidity; impairment; major depressive disorder; suicidal thoughts and behaviours.

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Conflict of interest statement

Dr Degenhardt reports grants from Seqirus and Indivior, outside the submitted work. In the past 3 years, Dr Kessler was a consultant for Datastat, Inc., Holmusk, RallyPoint Networks, Inc. and Sage Therapeutics. He has stock options in Mirah, PYM and Roga Sciences. Dr Navarro-Mateu reports non-financial support from Otsuka during 2019 outside the submitted work. Dr Stein has received research grants and/or honoraria from Lundbeck, Johnson & Johnson, Servier, Takeda and Vistagen.

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