OBJECTIVE: To determine whether there is a pattern of clinical characteristics at presentation that specifically predicts persistent major depression at 36 weeks follow-up. METHOD: Sixty-eight consecutive cases with a first episode DSM-III-R diagnosis of major depression were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode version and completed the mood and feelings self-report depression questionnaire (MFQ) at presentation and again at 36 weeks. RESULTS: At presentation, 63 (93%) had one or more comorbid psychiatric disorders (median = 3). At 36 weeks, 17 (25%) cases were recovered; 17 (25%) continued to meet criteria for one or more psychiatric disorder but not major depression; 34 (50%) still met criteria for DSM-III-R major depression, of whom 25 (73%) had been persistently depressed and 9 (27%) had recovered and subsequently relapsed. Major depression at follow-up was specifically predicted by the additive effect of three features at presentation, comorbid obsessive-compulsive disorder, higher MFQ score, and being older. Comorbid oppositional defiant disorder at presentation was a significant predictor of persistent psychiatric disorder. Individuals with persistent depression (n = 25) were more likely to have a longer duration of illness before presentation. CONCLUSION: Systematic assessment of comorbid psychiatric conditions at initial interview, together with the use, in older subjects, of a self-report questionnaire to determine subjective severity, will provide valid clinical information concerning the potential short-term outcome of major depression.
OBJECTIVE: To determine whether there is a pattern of clinical characteristics at presentation that specifically predicts persistent major depression at 36 weeks follow-up. METHOD: Sixty-eight consecutive cases with a first episode DSM-III-R diagnosis of major depression were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode version and completed the mood and feelings self-report depression questionnaire (MFQ) at presentation and again at 36 weeks. RESULTS: At presentation, 63 (93%) had one or more comorbid psychiatric disorders (median = 3). At 36 weeks, 17 (25%) cases were recovered; 17 (25%) continued to meet criteria for one or more psychiatric disorder but not major depression; 34 (50%) still met criteria for DSM-III-R major depression, of whom 25 (73%) had been persistently depressed and 9 (27%) had recovered and subsequently relapsed. Major depression at follow-up was specifically predicted by the additive effect of three features at presentation, comorbid obsessive-compulsive disorder, higher MFQ score, and being older. Comorbid oppositional defiant disorder at presentation was a significant predictor of persistent psychiatric disorder. Individuals with persistent depression (n = 25) were more likely to have a longer duration of illness before presentation. CONCLUSION: Systematic assessment of comorbid psychiatric conditions at initial interview, together with the use, in older subjects, of a self-report questionnaire to determine subjective severity, will provide valid clinical information concerning the potential short-term outcome of major depression.
Authors: Laura P Richardson; Elizabeth McCauley; Carolyn A McCarty; David C Grossman; Mon Myaing; Chuan Zhou; Julie Richards; Carol Rockhill; Wayne Katon Journal: Pediatrics Date: 2012-11-19 Impact factor: 7.124
Authors: Afaf H Khalil; Menan A Rabie; Mohamed F Abd-El-Aziz; Tarek A Abdou; Amany H El-Rasheed; Walaa M Sabry Journal: Child Adolesc Psychiatry Ment Health Date: 2010-10-10 Impact factor: 3.033
Authors: Darren B Courtney; Amy Cheung; Joanna Henderson; Kathryn Bennett; Marco Battaglia; John Strauss; Rachel Mitchell; Karen Wang; Peter Szatmari Journal: J Can Acad Child Adolesc Psychiatry Date: 2019-11-01