Social Factors for Major Depressive Disorder Negative Prognosis in Young Patients

Young patients are vulnerable to major depressive disorder (MDD) due to various identifiable environmental stressors. Knowing the overall participation of these factors in the development and/or maintaining depressive symptoms is very important when establishing a patient’s prognosis. The main objectives of this research were to define the most important social factors for negative prognosis in young patients diagnosed with MDD and to formulate a plan for approaching these factors during psychotherapy sessions. Methodology was based on searching medical databases (Pubmed, Medscape, Cochrane, EMBASE, PsychINFO) for information regarding negative prognosis factors in young patients with MDD and evidence based recommendation for processing these factors using psychotherapy. After applying inclusion and exclusion criteria for the review, we retained 9 researches that could be relevant to this paper’s objectives. The most relevant negative factors for prognosis in the targeted population are tensions in the familial relationships, including emotional or sexual abuse, parent divorce during early childhood, loss of a parent, loss of employment, loss of a close friend, alcohol use in his/her immediate environment, urban residence, cultural modelling of the feeling expression and willingness to seek treatment. Regarding the approach of these factors in psychotherapy data are more limited, and evidence based recommendations are still lacking. Therefore, we proposed an inclusive plan addressing most of the above mentioned factors. In conclusion, while several clinical and epidemiological data regarding negative prognosis factors in young patients MDD have been identified, more research in the field of how to deal in psychotherapy with these factors is needed.