OBJECTIVE: Depression is reported to be common in primary care settings and to have a high likelihood of relapse during the 4- to 6-month period following initial symptomatic improvement. However, most prospective studies of long-term treatment of depression have been conducted with patients selected for participation in placebo-controlled drug protocols or psychiatric clinics associated with tertiary referral centres. METHOD: We examined the treatment course and outcome of outpatients with major depressive episode treated in a primary care setting. The general practitioners were free to choose the treatment and its duration. Their only obligation was to assess the therapeutic outcome in terms of efficacy and safety and to perform a final evaluation at the end of the 6-month observation period or, if the patient was treated for a shorter period, at the end of the treatment. RESULTS: Of the 476 patients involved, 308 (64.7%) responded to treatment and remained well, 117 (24.6%) showed no response, and 51 (10.7%) had an early relapse after initial improvement. Among the studied demographic, clinical, and therapeutic factors, the history of recurrent depression was the only variable with a significant effect size in predicting the course of the illness. CONCLUSION: Patients with recurrent depression were at higher risk of relapse or nonresponse.
OBJECTIVE:Depression is reported to be common in primary care settings and to have a high likelihood of relapse during the 4- to 6-month period following initial symptomatic improvement. However, most prospective studies of long-term treatment of depression have been conducted with patients selected for participation in placebo-controlled drug protocols or psychiatric clinics associated with tertiary referral centres. METHOD: We examined the treatment course and outcome of outpatients with major depressive episode treated in a primary care setting. The general practitioners were free to choose the treatment and its duration. Their only obligation was to assess the therapeutic outcome in terms of efficacy and safety and to perform a final evaluation at the end of the 6-month observation period or, if the patient was treated for a shorter period, at the end of the treatment. RESULTS: Of the 476 patients involved, 308 (64.7%) responded to treatment and remained well, 117 (24.6%) showed no response, and 51 (10.7%) had an early relapse after initial improvement. Among the studied demographic, clinical, and therapeutic factors, the history of recurrent depression was the only variable with a significant effect size in predicting the course of the illness. CONCLUSION:Patients with recurrent depression were at higher risk of relapse or nonresponse.
Authors: Rebecca C Rossom; Leif I Solberg; Gabriela Vazquez-Benitez; Robin R Whitebird; A Lauren Crain; Arne Beck; Jürgen Unützer Journal: Psychiatr Serv Date: 2016-07-15 Impact factor: 3.084
Authors: S Döpfmer; M C Münchmeyer; T Natschke; W Herrmann; F Holzinger; R Burian; A Berghöfer; C Heintze Journal: Nervenarzt Date: 2018-01 Impact factor: 1.214
Authors: Bauke T Stegenga; Mirjam I Geerlings; Francisco Torres-González; Miguel Xavier; Igor Svab; Brenda W Penninx; Irwin Nazareth; Michael King Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2012-11-21 Impact factor: 4.328