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Background Life stressors and personal and social resources are associated with depression in the short-term, but little is known about their associations with the long-term course of depression. The current paper presents results of a 23-year study of community adults who were receiving treatment for depression at baseline (N=382). Methods Semi-parametric group-based modeling was used to identify depression trajectories and determine baseline predictors of belonging to each trajectory group. Results There were three distinct courses of depression: high severity at baseline with slow decline, moderate severity at baseline with rapid decline, and low severity at baseline with rapid decline. At baseline, individuals in the high-severity group had less education than those in the moderate-severity group, and more medical conditions than those in the moderate- and low-severity groups. Individuals in the high- and moderate-severity groups evidenced less psychological flexibility, and relied more on avoidance coping than individuals in the low-severity group. Limitations Results are limited by use of self-report and lack of information about depression status and life events in the periods between follow-ups. Conclusions These results assist in identifying groups at high risk for a long-term course of depression, and will help in selecting appropriate interventions that target depression severity, coping skills and management of stressors.


This is an Author's Accepted manuscript of an article whose final and definitive form, the Version of Record, has been published in the Journal of Affective Disorders, volume 150, issue 2, 2013. Find the published version of this article at this link.

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