Alberto Forte1, Ross J Baldessarini2, Leonardo Tondo3, Gustavo H Vázquez4, Maurizio Pompili5, Paolo Girardi5. 1. Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States. Electronic address: rbaldessarini@mclean.harvard.edu. 3. Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; Lucio Bini Mood Disorders Center, Cagliari, Italy; Lucio Bini Mood Disorders Center, Rome, Italy. 4. International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; Department of Neuroscience, Palermo University, Buenos Aires, Argentina. 5. NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy.
Abstract
BACKGROUND: Long-term symptomatic status in persons with major depressive and bipolar disorders treated clinically is not well established, although mood disorders are leading causes of disability worldwide. AIMS: To pool data on long-term morbidity, by type and as a proportion of time-at-risk, based on published studies and previously unreported data. METHODS: We carried out systematic, computerized literature searches for information on percentage of time in specific morbid states in persons treated clinically and diagnosed with recurrent major depressive or bipolar I or II disorders, and incorporated new data from one of our centers. RESULTS: We analyzed data from 25 samples involving 2479 unipolar depressive and 3936 bipolar disorder subjects (total N=6415) treated clinically for 9.4 years. Proportions of time ill were surprisingly and similarly high across diagnoses: unipolar depressive (46.0%), bipolar I (43.7%), and bipolar II (43.2%) disorders, and morbidity was predominantly depressive: unipolar (100%), bipolar-II (81.2%), bipolar-I (69.6%). Percent-time-ill did not differ between UP and BD subjects, but declined significantly with longer exposure times. CONCLUSIONS: The findings indicate that depressive components of all major affective disorders accounted for 86% of the 43-46% of time in affective morbidity that occurred despite availability of effective treatments. These results encourage redoubled efforts to improve treatments for depression and adherence to their long-term use.
BACKGROUND: Long-term symptomatic status in persons with major depressive and bipolar disorders treated clinically is not well established, although mood disorders are leading causes of disability worldwide. AIMS: To pool data on long-term morbidity, by type and as a proportion of time-at-risk, based on published studies and previously unreported data. METHODS: We carried out systematic, computerized literature searches for information on percentage of time in specific morbid states in persons treated clinically and diagnosed with recurrent major depressive or bipolar I or II disorders, and incorporated new data from one of our centers. RESULTS: We analyzed data from 25 samples involving 2479 unipolar depressive and 3936 bipolar disorder subjects (total N=6415) treated clinically for 9.4 years. Proportions of time ill were surprisingly and similarly high across diagnoses: unipolar depressive (46.0%), bipolar I (43.7%), and bipolar II (43.2%) disorders, and morbidity was predominantly depressive: unipolar (100%), bipolar-II (81.2%), bipolar-I (69.6%). Percent-time-ill did not differ between UP and BD subjects, but declined significantly with longer exposure times. CONCLUSIONS: The findings indicate that depressive components of all major affective disorders accounted for 86% of the 43-46% of time in affective morbidity that occurred despite availability of effective treatments. These results encourage redoubled efforts to improve treatments for depression and adherence to their long-term use.
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