andrews et al found that of individuals with a mental disorder had this disorder a year earlier already hughes and cohen found a majority of patients with a depressive disorder still suffering from recurrent depressive episodes ten years later chronicity has also consistently been found to be strongly related to a high utilisation of medical services eg fasel et al and to be a decisive factor for longterm sickness absence and disability eg bergh et al in schizophrenic disorders for example around show substantial social and vocational impairments or residual symptoms moller et al