Characteristics of chronic outpatients with unipolar depression

Among the long-term clinic attenders with unipolar depression, there are some who continue to visit the hospital after their affective symptoms have long abated. They constitute "new chronic" psychiatric outpatients and remain consumers of medical resources. We studied these patients' characteristics through a case-control study with former patients who received treatment for the same diagnosis but are currently not under treatment and not depressed. The long-term clinic attenders tended to show fewer psychomotor symptoms and criteria symptoms than the control group. Although the groups were similar in terms of the severity of current depressive symptoms, the patients showed significantly poorer functioning in many areas of social adjustment. With regard to premorbid psychosocial variables, the chronic clinic attenders reported poorer friendship relationships during their adolescence, poorer premorbid global functioning and higher extraversion scores. These findings support the hypothesis that the social maladjustment of the chronic clinic attenders is not a sequela of their affective disorders but represents the patients' enduring characteristics.