This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Mood Disorders, Subject name: Psychiatry
Which of the following is not an indicator of a good prognosis for major depressive disorder? 
Select and explain. 
A. Stable family functioning, B. No more than one previous hospitalization, C. A history of more than one previous depressive episode, D. Advanced age of onset
C: A history of more than one previous depressive episode
Answer: C: A history of more than one previous depressive episode 
Explanation: Ans. C. A history of more than one previous depressive episodeA history of more than one previous depressive episode is not an indicator of a good prognosis for major depressive disorder. Rather, it increases the possibility for a poor prognosis. Other indicators of a poor prognosis include coexisting dysthymic disorder, abuse of alcohol and other substances, and anxiety disorder symptoms. Men are more likely than women to experience a chronically impaired course.Mild episodes, the absence of psychotic symptoms, and a short hospital stay are good prognostic indicators. Psychosocial indicators of a good course include a history of solid friendships during adolescence, stable family functioning, and generally sound social functioning for the 5 years preceding the illness. Additional good prognostic signs are the absence of a comorbid psychiatric disorder and of a personality disorder, no more than one previous hospitalization for major depressive disorder, and an advanced age of onset.