Recidivism in major depressive disorder

Background: While recidivism has been well studied in psychotic disorders, little has specifically been done to determine what differences exist between patients admitted multiple times compared with once for major depressive disorder (MDD). Method: The records of patients admitted with MDD to a large military medical center were reviewed during the years 1991-1995. Recidivists were 46 consecutive patients admitted three or more times during the period. The comparison sample was 50 consecutive patients admitted for the first time in 1993 without subsequent admission to our hospital. Patient groups were compared for age, gender, comorbidity, and the presence of medical conditions contributing to their admission. Results: Repeat hospital admissions for MDD were common. Recidivists were more likely to be older, suffer recurrent depression, receive a personality disorder diagnosis, receive ECT or have a medical condition contributing to their admission, than patients admitted once. Alcohol use disorders or other Axis I disorders did not predict recidivism. Conclusions: For some patients the morbidity of MDD in the form of frequent admissions is considerable, perhaps as severe as for patients with psychotic disorders. Frequent hospitalizations may result from recurrent MDD with or without personality disorder.