Prevalence of, and risk factors for, recurrent episodes of depressive or anxiety disorders: A Systematic review

Abstract

Abstract Background Previous research papers have suggested that with each successive episode of depression or anxiety disorder the chance of recurrence significantly increases. However, the causes of such recurrences have been less well studied. Indeed, studies often report multiple, often conflicting, risk factors. The current review aimed to systematically collate recent literature on this topic to both estimate the likelihood of recurrence after an initial episode of depression or generalised anxiety disorder and elucidate factors which make recurrence more or less likely. Methods In May 2022, searches were conducted across four electronic databases: Medline, Global Health, PsycInfo and Embase for records published in English since 2018 in peer-reviewed journals reporting on the prevalence of recurrence of depressive/anxiety disorders, or risk factors for recurrence of depressive/anxiety disorders. Results A total of 2,173 citations were screened and 36 papers were included in the review. Recurrence rate reported in the retained papers ranged from 11.6–91.8%, with a mean and median recurrence rate of 42%. There was limited consensus on factors associated with recurrence, but previous experience of trauma, especially during childhood, was found to be the most predictive. Limitations: Grey literature was not included within this review which may have resulted in a loss of potentially important studies. Conclusion We found no evidence that disease-related factors were predictive of relapse. Instead, our results also showed that, other than exposure to prior trauma, there was no clear consensus as to what risk factors impacted risk of recurrence. Suggestions for future research are suggested.