Clinical factors seem the most important predictors of recurrence. Data from studies performed in the general population and primary care on the recurrent course of MDD are scarce.

Although half of those affected with MDE recovered rapidly, the risk of chronicity (duration 24 months or more) was considerable. This underlines the necessity of diagnosing and treating those at risk.

High levels of psychiatric comorbidity exist in the general population. The risk factor profiles for comorbid disorders differ considerably from those for pure disorders. Primary prevention of secondary disorders in populations with a history of a primary disorder are important for reducing psychiatric burden.

Poor outcome of major depression is frequent in the general population. Largely the same risk factors are involved as in clinical populations.