Major depression is one of the most prevalent and debilitating personal and public health conditions worldwide. Less appreciated is that depression's tremendous burdens are not shared equally among all who become depressed. Some will suffer recurrences over the rest of their lives, whereas half or more will never have a recurrence. Based on these two distinctive life course prototypes, we propose a subtype distinction for research on the origins and lifetime course of major depression. A pressing goal is to determine at the time of depression's first onset who will follow which clinical trajectory. The lack of recognition of this distinction has resulted in many obstacles, including conceptual biases, methodological oversights, and definitional dead ends. Current theories are reviewed and compared. The implications for contemporary diagnostic controversies, reevaluating research on treatment and prevention, and enhancing the predictive strength of traditionally weak indicators of recurrences and recurrent depression are discussed.

中文翻译：

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重度抑郁症及其复发：生命历程很重要


重度抑郁症是全世界最普遍和最使人衰弱的个人和公共卫生状况之一。鲜为人知的是，抑郁症的巨大负担并没有在所有抑郁症患者之间平均分担。有些人会在他们的余生中复发，而一半或更多的人永远不会复发。基于这两个独特的生命历程原型，我们提出了一种亚型区分，用于研究重度抑郁症的起源和终生过程。一个紧迫的目标是确定在抑郁症首次发作时谁将遵循哪种临床轨迹。缺乏对这种区别的认识导致了许多障碍，包括概念偏见、方法论疏忽和定义死胡同。对当前的理论进行了回顾和比较。讨论了对当代诊断争议的影响，重新评估治疗和预防的研究，以及增强传统上较弱的复发和复发性抑郁指标的预测强度。