Recurrent brief depression in general practice. Clinical features, comorbidity with other disorders, and need for treatment.

This study tested the clinical validity of the new diagnostic entity "recurrent brief depression" (RBD) in 300 general practice patients who participated in the WHO study on "Psychological Problems in Primary Care." Patients with current RBD reported of episodes major depression more often than did a comparison group of nondepressed general practice patients: however, the majority of RBD patients had not received a diagnostic of any well-established affective disorder during the last 12 months. RBD patients (without MDE) did not suffer more frequently from dysthymia, from nonaffective psychiatric disorders, or from somatic disorders. However, RBD was associated with a higher percentage of previous suicide attempts and of ideation of suicide and death. RBD was accompanied by substantial psychosocial impairment; psychosocial impairment in RBD patients could not be explained by excess comorbidity. Thus, the clinical validity of RBD was demonstrated although doubts about the appropriateness of the definition remained. This new diagnostic category needs more attention as only as small minority of patients with RBD received specific antidepressant treatment.