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Predictive Factors of Recurrence in Patients with Major Depressive Disorder

Published online by Cambridge University Press:  26 August 2025

N. Kissa*
Affiliation:
University Psychiatric Hospital Arrazi, salé, Morocco
N. Ait Bensaid
Affiliation:
University Psychiatric Hospital Arrazi, salé, Morocco
A. Korchi
Affiliation:
University Psychiatric Hospital Arrazi, salé, Morocco
F. Laboudi
Affiliation:
University Psychiatric Hospital Arrazi, salé, Morocco
A. Ouanass
Affiliation:
University Psychiatric Hospital Arrazi, salé, Morocco
*
*Corresponding author.

Abstract

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Introduction

Major depressive disorder (MDD) presents as episodes lasting at least two weeks, affecting mood, cognitive, and neurovegetative functions, leading to significant distress [1]. Remission is challenging, with rates of only 30-50% after 6-8 weeks of antidepressant treatment [2]. The STAR*D study shows that 30-40% of patients achieve remission with first-line treatment, and a third fail even after four trials [3]. Recurrence risk is high, reaching 90% after three or more episodes [4][5].

Objectives

The study aims to identify predictive factors for recurrence in major depressive disorder patients at Arrazi Psychiatric Hospital in Salé and to assess the impact of sociodemographic, biological, psychological, socio-environmental, and treatment-related factors on recurrence risk.

Methods

This retrospective, descriptive, and analytical study will collect data from medical records of major depressive disorder patients at Arrazi Psychiatric Hospital in Salé, including sociodemographic, clinical, and therapeutic details. Standardized data extraction ensures anonymity, and factors will be analyzed through univariate, bivariate, and multivariate statistical methods (logistic regressions), with adjusted odds ratios calculated for significant factors and a p-value threshold of < 0.05 applied.

Results

The study shows that women represent approximately 60-70% of patients, with an average age of 30-40 at the first episode and often limited social support in 50-60% of cases. About 40% present psychiatric comorbidities, and 20-30% have physical comorbidities. Nearly 50% of patients have recently experienced stressful events, and 30-40% live in precarious conditions. Therapeutic adherence is insufficient for 30-40% of cases, and 25-35% discontinued treatment prematurely. Meanwhile, those who benefited from combined therapy represent 50-60%, showing a lower recurrence risk.

Conclusions

The recurrence of major depressive disorder poses a major clinical challenge, impacting long-term patient management. Identifying risk factors can enhance preventive interventions and therapeutic follow-up, while an integrative approach considering sociodemographic and psychological factors may help reduce relapse rates. These findings underscore the need for further research into the mechanisms of recurrence in major depressive disorder.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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