[Depressive disorders. Sociodemographic factors predicting therapeutic response]

The choice of an antidepressant according to the possible course of depression is a fundamental step in the treatment approach. Socio-demographic factors are considered in order to predict the outcome of depression receiving an adequate treatment. Only a few studies deal with this topic, probably because of the role the same factors play in the occurrence of depression. The influence of age, sex, marital status, socio-economic level and life events on compliance with treatment is considered as well as main clinical issues such as treatment resistance, risk of chronicity and of suicide. Generally speaking, socio-demographic factors do not constitute a major parameter when selecting an antidepressant. They are useful to identify patients at risk requiring special therapeutic measures. The poor prognosis of depression in males after 65 has must be emphatized, as well as the negative influence of life events occurring during the course of endogenous depression. Conversely, a decrease in the number of life events or a life event experiencing a new start in life, play an important role in the improvement of depression according to Brown. Those factors remain in the background of the pathological process and of its evolution, acting indirectly, with a poor association power. Moreover, most of those predictors have been determined a posteriori.