A 42-Year-Old Man Comes to the Office Due to Persistent

A 42-year-old man comes to the office due to persistent sadness, weight gain, and fatigue over the past 4 months.  The patient is a dentist who has had difficulty waking up in the morning for clinic.  He says, "I used to be really efficient, but now I always run 2 hours behind schedule."  He has been eating "lots of fast food" for dinner and feels exhausted every day.  Following a divorce 3 years ago, the patient was diagnosed with major depressive disorder, which improved after a few months of treatment with paroxetine.  The patient has a history of separation anxiety disorder as a child, which resolved with psychotherapy.  Family history is significant for generalized anxiety disorder in his mother.  Physical examination and laboratory evaluation are normal.  After discussion of treatment options, the patient decides to start sertraline.  His symptoms resolve by the follow-up appointment 6 months later.  Which of the following features is an indication for long-term maintenance of antidepressant therapy in this patient?

A) Age of onset of initial depressive episode
B) Duration of current depressive episode
C) Family history of anxiety disorder
D) History of separation anxiety disorder
E) Number of prior depressive episodes
F) Presence of atypical depressive features

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