Major depression is a debilitating and recurrent disorder with a substantial lifetime risk and a high social cost.

1. - To establish the course of the first major depressive episode (MDE) in a population of students.

2. - To identify the various factors involved in this process.

Retrospective and descriptive study on 40 students followed in Psychopedagogie’ consultation in the department of Psychiatry B, Hedi chaker hospital in Sfax Tunisia from 2009 to 2013. The statistical analysis was performed by the SPSS (version 18).

The average age of the group was 22,8 years. Twenty-three women (57,5%) were included. All of patients were single. The socioeconomic level of the group was fair in 62,5% of cases. Twelve subjects had a family history of psychiatric illness. Prevalence of unipolar depression was 82,5%. Majority of patients were treated with only pharmacological means (77,5%). The general evolutif course in our subjects tends to improvement (37,5%). Six patients had a complete recovery. The persistence of residual symptoms was found in 12 patients. Deterioration in social and professional functioning was reported in12 patients. Six patients have had relapse. The recurrence of MDE was reported in 2 patients. Chronicity was founded in 4 patients. Two patients had a new suicide risk. One patient had an emergence of mood episode. No patient had spontaneous improvement. Nine patients have stopped the follow. The main reason of worsening was the emergence of an intercurrent stress factor (52,5%).

The negative impact of depression in our patients explains the necessity of a well adapted management.