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

Annelieke M. Roest, Ymkje Anna De Vries, Ali Al-Hamzawi, Jordi Alonso, Olatunde O. Ayinde, Ronny Bruffaerts, Brendan Bunting, José Miguel Caldas De Almeida, Giovanni De Girolamo, Louisa Degenhardt, Silvia Florescu, Oye Gureje, Josep Maria Haro, Chiyi Hu, Elie G. Karam, Andrzej Kiejna, Viviane Kovess-Masfety, Sing Lee, John J. McGrath, Maria Elena Medina-MoraFernando Navarro-Mateu, Daisuke Nishi, Marina Piazza, José Posada-Villa, Kate M. Scott, Juan Carlos Stagnaro, Dan J. Stein, Yolanda Torres, Maria Carmen Viana, Zahari Zarkov, Ronald C. Kessler, Peter De Jonge

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalEpidemiology and Psychiatric Sciences
Publication statusPublished - 11 Nov 2021


  • Comorbidity
  • impairment
  • major depressive disorder
  • suicidal thoughts and behaviours


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