Thought the methodology of evaluation and the subsequent analysis are fairly standard, there are a number of discrepancies noted. The authors are not exposed to the events leading to depression of the initial cohort, and whether it was of mild or severe nature. Whether the phase was preceded by same family or economic disaster, or were the patients genetically prone to the illness is not laid out.
2 How were the previous cohort rehabilitated If the cause of the previous depression was an acute temporary event, the individual has a greater chance to come out and carry on with life. The authors needed to correlate the present incidence of depression with the causative factor initially
3 The authors have given an incidence of 30% mortality in these individuals. It is probably more important to actually discuss the cause of the mortality also. We do not know the ages of the patients, and the exact etiology. The causation of death can be natural in some percentage, and how many of the dead were actually suffering from persistent depression only can point this to be the cause.
The questionnaire has not been included in the journal.