Mauling of the “Celtic Tiger”: Clinical characteristics and outcome of first-episode depression secondary to the economic recession in Ireland

Abstract Background There is a dearth of studies describing clinical characteristics and outcome of patients who present with mood disorders related to economic recession. Aims To describe a cohort of patients admitted with first-episode depression related to the Irish economic recession and compare this cohort with all other first-episode depressives admitted during the same time period (2009–2010). Methods A cohort of 137 patients admitted with first-episode depression to an independent university teaching hospital was prospectively identified and followed up from admission over 2 years (mean follow-up 430 days, s.d. 176 days). The cohort was divided into “Celtic Tiger” (patients with first-episode depression secondary to the economic recession) and non-Celtic Tiger control patients (other first-episode depressed patients). Both groups were compared in terms of clinical characteristics at baseline and outcome over follow-up. Results The number of admissions due to first depressive episodes were higher in recession years 2009/10 than in pre-recession years 2008/9. Celtic Tiger patients were predominantly male and more severely depressed with more marked suicidal ideation ( χ 2 , p χ 2 , p =0.013), less likely to recur ( χ 2 , p p p =0.001). The Celtic Tiger patients spent more time asymptomatic and less time at full and subthreshold depression levels over follow-up. Limitations Study setting of centre specializing in affective disorders treatment, retrospective nature of follow-up after initial prospective interview and lack of patient follow-up interview. Conclusion The study describes a subgroup of patients with severe depression associated with economic recession with likely high suicide risk but very favourable outcome.