episode at first contact, 36.8% did not have a second psychiatric treatment contact within the hospital care setting either because they did not experience relapse/recurrence or because they were treated in a primary care setting (general practitioners or private specialists in psychiatry). On the other hand, as the number of depressive episodes increases for a given patient, it is becoming increasingly clear for the clinician, patient and relatives that the patient has a depressive disorder with a high recurrence of episodes. One may presume that the likelihood that such a patient will continue into the secondary psychiatric setting increases with the number of depressive episodes, thus resulting in an increase in the proportion of milder depressive episodes with the number of treatment contacts in the present study sample. I am unable to investigate the direction of such a possible bias, as I have no data on patients treated for depressive episodes in primary care. In summary, bias cannot be excluded as a possible explanation of the present findings. Fourth, although the prevalence of auxiliary diagnoses increased from 17.2% at the first contact to 21.2% at the tenth, comorbidity did not explain the results, as the prevalence of an auxiliary diagnosis was inversely associated with the severity of the depressive episodes (see Results). Finally, even though a patient should have the diagnosis of a single depressive episode according to ICD -- 10 only when no prior depressive episodes have occurred, it is possible that patients may have been seen in the