About 60 % of the subjects with a first episode of major depression will present a second episode lifetime. Thus, it is important to determine the risk factors of recurrence.

To identify the risk factors of depressive recurrence.

It is a retrospective study conducted in university hospital of Mahdia including 150 patients hospitalized in psychiatric ward for major depressive disorder according to DSM-IV-TR. Data were collected using a questionnaire of 89 items. Statistical analysis was done using the Kaplan-Meier method. The Cox test was used to check for recurrence risk factors.

The sample was divided into:

• Group 1: diagnosed with major depressive disorder, single episode (MDD, n = 63)

• Group 2: diagnosed with recurrent major depressive disorder (MDDr, n = 87)

Family history of mood disorders were found in 25,4% and 59,7% of patients in respectively group 1 and 2. The age of onset was less than 25 years in 34.48% of Group 2 against 22.2% in group 1. Residual symptoms were similar in both groups. The mean time to recurrence was 109 months. Multivariate analysis retained 5 risk factors: early age of onset disorders (p = 0.02), family history of mood disorder (p = 0.04), the severity of depressive index episode (p = 0.03), the persistence of residual symptoms (p = 0.02) and early interruption of the treatment (p = 0.04).

The identification of risk factors for recurrence before a first depressive episode is very important to prevent recurrence and chronicity.