Author:
VAN LONDEN L.,MOLENAAR R. P. G.,GOEKOOP J. G.,ZWINDERMAN A. H.,ROOIJMANS H. G. M.
Abstract
Background. A Dutch cohort of predominantly out-patient
DSM-III-R
major depressive patients
was followed for 3 to 5 years after start of treatment in a
psycho-neuro-endocrinological prediction
study. The study design permitted description of the course of
remissions, relapses and recurrences.Methods. Pharmacological treatment was standardized, psychotherapy
was tailored to the needs of
the patient, follow-ups were done monthly until 3 years or more after the
initial recruitment.Results. After 9 months 49% of the patients had reached full
remission and 45% were in partial
remission. During the following 3 to 5 years 82% of the patients had reached
a period of full
remission. Sixteen per cent of the patients needed 2 years or more
before full remission. A relapse
or recurrence rate of 41% within 5 years was found. Patients with residual
symptoms relapsed
particularly in the first 4 months after remission, while patients
without residual symptoms recurred
mainly after 12 months after remission. Previous depressive episodes and
psychoticism predicted
relapse. Psychomotor retardation at inception predicted a longer time to
partial remission.Conclusion. In most cases, major depression is a seriously
impairing episodic disease. This is also
true for a sample of predominantly out-patients treated at a university
clinic.
Publisher
Cambridge University Press (CUP)
Subject
Psychiatry and Mental health,Applied Psychology
Cited by
109 articles.
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