Depressive disorders are characterized by high rates of recurrence and chronic developments, particularly in treated patient samples. The identification of relevant predictors related to course and outcome is of particular importance for tertiary prevention. In this study, we assessed factors influencing the prospective five-year course and outcome of illness in a cohort of depressed patients.

A cohort of 71 patients suffering from major depression or dysthymia was comprehensively assessed one, six, 36, and 60 months after discharge from inpatient treatment. Predictor measures included demographic and clinical variables, as well as cognitive vulnerability and social support measures assessed one month after discharge. Outcome variables were time in remission, relapse/recurrence rates, and course of psychosocial functioning over the 5-year interval.

During the 5-year observation period, 25% of the patients spent less than 50% of time in remission. More than 50% of those who were out of episode after discharge relapsed or sufferend from a new episode during the 5 years, three patients developed a bipolar course. Predictors of nonremission, relapse/recurrence, and psychosocial functioning were only partly overlapped.

We found further evidence for a highly recurrent and chronic course of illness in hospitalized depressed patients. Clinical and research implications will be discussed at the conference.