Risk factors for chronic depression—a systematic review

Hölzel, Lars; Härter, Martin; Reese, Christina; Kriston, Levente

doi:10.1016/j.jad.2010.03.025

Cited by 285Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Risk factors for chronic depression—a systematic review

Hölzel, Lars, Härter, Martin, Reese, Christina, Kriston, Levente·2011·Journal of Affective Disorders

DOI 10.1016/j.jad.2010.03.025

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Abstract

Background One of five patients with an acute depressive episode develops chronic depression. Risk factors for a current depressive episode to become chronic are insufficiently known. This review was conducted to examine which factors represent a risk factor for the development of chronic depression for patients diagnosed with a depressive episode.Method Medline, Psycinfo, ISI Web of Science, CINHAL and BIOSIS Previews were searched up until September 2007, complemented by handsearching in the December 1987 to December 2007 issues of Journal of Affective Disorders and investigating reference lists of included articles and existing reviews. On the basis of a formal checklist, two investigators independently decided which studies to include or exclude.Results 25 relevant primary studies with a total of 5192 participants were included in the systematic review. Overall the methodological quality of the included studies was found to be sufficient. Data synthesis was performed via vote counting. The following risk factors were identified: younger age at onset, longer duration of depressive episode, and family history of mood disorders. Psychological comorbidity i.e. anxiety disorders, personality disorders and substance abuse, low level of social integration, negative social interaction and lower severity of depressive symptoms repeatedly appeared concurrently with chronic depression.Limitations Most included studies were cross-sectional thus drawing causal conclusions with regard to risk factors proved to be difficult.Conclusion Risk factors for a current depressive episode to become chronic were identified. To date only few significant longitudinal studies on this topic are available.

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Before the pandemic, women, younger adults, people with less education or lower socioeconomic position, Black, Asian, and minority ethnic individuals, and people living alone were more likely to have higher depression and anxiety than their comparison groups.
“Women, younger adults, individuals with lower educational attainment and socioeconomic position, individuals from Black, Asian, and minority ethnic (BAME) backgrounds, and individuals living alone are more likely to experience higher levels of depression and anxiety than men, older adults, individuals with higher educational attainment and socioeconomic position, individuals from white backgrounds”
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Authors: Hölzel, L., Härter, M., Reese, C., & Kriston, L.
Affiliations: University Medical Center Freiburg (DE)
University of Freiburg (DE)
University Medical Center Hamburg-Eppendorf (DE)
Corresponding author: Hölzel, Lars
ORCID: Hölzel, Lars
Härter, Martin
Reese, Christina
Kriston, Levente
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2011-03
Volume: 129
Issue: 1-3
Pages: 1-13
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2010.03.025
OpenAlex: W2038955452
Cited by: 285
References: 54
Citations by year: 2026: 14 · 2025: 17 · 2024: 28 · 2023: 21 · 2022: 20 · 2021: 20 · 2020: 25 · 2019: 20 · 2018: 12 · 2017: 24 · 2016: 16 · 2015: 14 · 2014: 20 · 2013: 16 · 2012: 7
FWCI: 1.24
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: chronic depression, dysthymia, risk factors, depressive episodes, age of onset, depressive episode duration, family history of mood disorders, psychological comorbidity, anxiety disorders, personality disorders, substance abuse, social integration, negative social interactions, depression severity
MeSH terms: Anxiety Disorders, Depressive Disorder, Family, Humans, Interpersonal Relations, Personality Disorders, Risk Factors, Time Factors, Comorbidity, Age of Onset, Substance-Related Disorders

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Risk factors for chronic depression—a systematic review

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