Prevalences and differences of depressive symptomology among first-episode of depression and recurrent depression: An analysis of data from NSSD.

Abstract

Background: The study was designed to fully map and display the hierarchy of depressive symptomology among first-episode and recurrent major depressive disorder (MDD) patients.

Methods: This cross-sectional study included 3249 MDD patients from the National Survey on Symptomatology of Depression (NSSD). The prevalences of 64 sets of depressive symptoms in first-episode and recurrent MMD were fully described and compared. Logistic regression and random forest models were used to assess the relative importance of the symptoms in distinguishing first-episode MDD from recurrent MDD.

Results: The prevalences of the total 64 sets of the symptoms ranged from 5.7 % to 80.0 %, and depressed mood (80.0 %), pleasure loss (76.0 %), interest loss (72.0 %), low energy (72.0 %), later insomnia (65.0 %) were the top 5 symptoms. 24 symptoms that had a significantly higher prevalence in recurrent MDD patients than those of first-episode MDD patients were identified, especially memory loss (59.0 % vs. 49 %, p < 0.001), suicide history (17.9 % vs. 8.9 %), sense of decreased ability (69.7 % vs. 60.8 %, p < 0.001). The results from logistic regression and random forest analyses consistently indicated that the differences in the prevalences of suicidal behavior, memory loss, and late insomnia may be the most important distinguishing characteristics between first-episode and recurrent MDD.

Conclusion: The findings may help develop screening tools for MDD in clinics and provide clues for further mechanistic studies for the recurrence of MDD.

Limitations: Because of the study's cross-sectional design, causal conclusions could not be drawn between the differences in the prevalences of symptoms and recurrence of MDD.