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¿El período sin tratamiento del trastorno depresivo mayor puede influir en la evolución a largo plazo de esta enfermedad?

Published online by Cambridge University Press:  01 May 2008

A. Cario Altamura ,
Bernardo Dell’Osso ,
Serena Vismara  and
Emanuela Mundo
A. Cario Altamura
Affiliation:
Departamento de Psiquiatría, Universidad de Milán, Fundación IRCCS, Hospital General Policlínico, Mangiagalli e Regina Elena, Vía F. Sforza 35, 20122Milán, Italia
Bernardo Dell’Osso
Affiliation:
Departamento de Psiquiatría, Universidad de Milán, Fundación IRCCS, Hospital General Policlínico, Mangiagalli e Regina Elena, Vía F. Sforza 35, 20122Milán, Italia
Serena Vismara
Affiliation:
Departamento de Psiquiatría, Universidad de Milán, Fundación IRCCS, Hospital General Policlínico, Mangiagalli e Regina Elena, Vía F. Sforza 35, 20122Milán, Italia
Emanuela Mundo
Affiliation:
Departamento de Psiquiatría, Universidad de Milán, Fundación IRCCS, Hospital General Policlínico, Mangiagalli e Regina Elena, Vía F. Sforza 35, 20122Milán, Italia
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Resumen

El objetivo de este estudio naturalista fue investigar la influencia posible del período sin tratamiento (PST) del trastorno depresivo mayor (TDM) sobre la evolución a largo plazo de la enfermedad. Ciento trece pacientes con TDM recurrente, según los criterios del DSMIV- TR, seguidos durante 5 años, se seleccionaron y entrevistaron, y se revisaron sus historias clínicas. El PST se definió como el intervalo entre el inicio del primer episodio depresivo y el primer tratamiento antidepresivo. La muestra se dividió en dos grupos según el PST: un grupo con un PST ≤ 12 meses (n = 75) y otro con un PST > 12 meses (n=38). Las principales variables demográficas y de evolución clínica de los dos grupos se compararon usando el test de la t de Student o de χ2. Los pacientes con un PST más prolongado eran más jóvenes en el inicio (t=2,8, p=0,006) y la duración de la enfermedad fue mayor (t=3,20, p=0,002) que en los pacientes con un PST más corto. Además, el número total de episodios depresivos que ocurrieron antes del primer tratamiento antidepresivo fue mayor en el grupo con PST más prolongado (t=-2,223, p < 0,03). Aunque están limitadas por la naturaleza retrospectiva del estudio, estas conclusiones preliminaries podrían indicar que un PST más prolongado puede influir negativamente en la evolución del TDM. Son necesarios estudios prospectivos de mayor tamaño para investigar con más profundidad el papel del PST en el TDM.

Keywords

Período sin tratamiento (PST)Trastorno depresivo mayor (TDM)Evolución a largo plazo
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 15 , Issue 4 , May 2008 , pp. 176 - 180
Copyright
Copyright © European Psychiatric Association 2008

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References

Bibliografía

[1]Altamura, ACBassetti, RSassella, FSalvadori, DMundo, E. Duradon of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study. Schizophrenia Research 2001; 52(1-2): 29–36.CrossRefGoogle ScholarPubMed
[2]Altamura, ACBassetti, RBigotti, SPioli, RMundo, E. Clinical variables related to suicide attempts in schizophrenic patients: a retrospective study. Schizophrenia Research 2003; 60(l): 47–55.CrossRefGoogle ScholarPubMed
[3]Altamura, ACSantini, ASalvadori, DMundo, E. Duration of untreated illness in panic disorder: a peor outcome risk factor? Neuropsychiatric Disease and Treatment 2005; 1 (4): 345-7.Google Scholar
[4]Altamura, ACDell'Osso, BMundo, EDell'Osso, L. Duration of untreated illness in major depressive disorder: a naturalistic study. International Journal of Clinical Practice 2007; 61 (10): 1697-700.CrossRefGoogle ScholarPubMed
[5] American Psychiatric Association. Diagnostic and statistical manual of mental disorders [text revisión], 4th ed. Washington, DC: Ameri-can Psychiatric Association; 2000.Google Scholar
[6] American Psychiatric Association. Practice guidelines for the treatment of psychiatric disorders [compendium], Arlington, VA: Ameri-can Psychiatric Association; 2006. p. 441–525.Google Scholar
[7]Baethge, CGruschka, PSmolka, MNBerghofer, ABschor, TMuller-Oerlinghausen, B, et al. Effectiveness and outcome predictors of long-term lithium prophylaxis in unipolar major depressive disor-der. Journal of Psychiatry & Neuroscience 2003; 28: 355-61.Google Scholar
[8]Baethge, CTondo, LBratti, IMBschor, TBauer, MViguera, AC, et al. Prophylaxis latency and outcome in bipolar disorders. Canadian Journal of Psychiatry 2003; 48(7): 449-57.CrossRefGoogle ScholarPubMed
[9]Bottlender, RSato, TJager, MWegener, UWittmann, JStrauss, A, et al. The impact of the duration of untreated psychosis prior to first psychiatric admission on the 15-year outcome in schizophrenia. Schizophrenia Research 2003; 62(l-2): 37–44.CrossRefGoogle Scholar
[10]Craig, TJBromet, EJFennig, STanenberg-Karant, MLavelle, JGalambos, N, et al. Is there an association between duration of untreated psychosis and 24-month clinical in first admission series? Ame-rican Journal of Psychiatry 2000; 157: 60-6.CrossRefGoogle ScholarPubMed
[11]Crow, TJMcMillan, JFJohnson, ALJohnstone, EC. A randomized controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry 1986; 148: 120-7.CrossRefGoogle ScholarPubMed
[12]First, MBSpitzer, RLGibbon, MWilliams, JBW. Structured clinical interview for DSM-IVAxis I (SCID-I) [clinician versión], Washington DC: American Psychiatric Press; 1997.Google Scholar
[13]Goldberg, JFErnst, CL. Features associated with the delayed initiation of mood stabilizers at illness onset in bipolar disorder. Journal of Clinical Psychiatry 2002; 63( 11 ): 985-91.CrossRefGoogle ScholarPubMed
[14]Gollan, JRaffety, BGortner, EDobson, K. Course profiles of earlyand adult-onset depression. Journal of Affective Disorders 2005; 86(l): 81-6.CrossRefGoogle Scholar
[15]Gormley, NO'Leary, DCostello, F. First admission for depression: is the “no-treatment interval” a critical predictor of time to remission? Journal of Affective Disorders 1999; 54(l-2): 49–54.CrossRefGoogle ScholarPubMed
[16]Hamilton, M. A rating scale for depression. Journal of Neurology, Neuro-surgery and Psychiatry 1960; 23: 56–62.CrossRefGoogle ScholarPubMed
[17]Ho, BCAndreasen, ACFlaum, MNopoulos, PMiller, D. Untreated initial psychosis: its relation to quality of life and symptom remission in first-episode schizophrenia. American Journal of Psychiatry 2000; 157: 808-15.CrossRefGoogle ScholarPubMed
[18]Klein, DN. Depressive personality in the relatives of outpatients with dysphoric disorder and episodic major depressive disorder and ñormal Controls. Journal of Affective Disorders 1999; 55( 1): 19–27.CrossRefGoogle Scholar
[19]Loebel, ADLieberman, JAAlvir, JMMayerhoff, DIGeisler, SHSzymanski, SR. Duration of psychosis and outcome in first episode schizophrenia. American Journal of Psychiatry 1992; 149: 1183-8.Google ScholarPubMed
[20]Marshall, MLewis, SLockwood, ADrake, RJones, P, CroudaceT. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Archives of General Psychiatry 2005; 62(9): 975-83.CrossRefGoogle ScholarPubMed
[21]McGlashan, TH. Predictors of short, médium and long-term outcome in schizophrenia. American Journal of Psychiatry 1986; 143( 1 ): 50-5.Google Scholar
[22]Mundo, ESantini, ASalvadori, DAltamura, AC. Duration of untreated illness (DUI) and clinical course in bipolar disorder [abstract]. Presented at the 158th American Psychiatric Association annual meeting, May 21-26, 2005, Atlanta, GA, USA.Google Scholar
[23]Norrholm, SDOuimet, CC. Altered dendritic spine density in animal models of depression and in response to antidepressant treatment. Synapse 2001; 42: 151-63.CrossRefGoogle ScholarPubMed
[24]Olney, JWFarber, NB. Glutamate receptor dysfunction and schizophrenia. Archives of General Psychiatry 1995; 52: 998–1007.CrossRefGoogle Scholar
[26]Rund, BRMelle, IFriis, SLarsen, TMidboe, LJOpjordsmoen, S, et al. Neurocognitive dysfunction in first episode psychosis: correlates with symptoms, premorbid adjustment, and duration of untreated psychosis. American Journal of Psychiatry 2004; 1613: 466-72.CrossRefGoogle Scholar
[27]Sareen, JJagdeo, ACox, BJClara, Iten Have, MBelik, SL, et al. Perceived barriers to mental health Service utilization in the United States, Ontario, and the Netherlands. Psychiatric Services 2007; 58(3): 357-64.CrossRefGoogle ScholarPubMed
[28]Scott, JEccleston, DBoys, R. Can we predict the persistence of depression? British Journal of Psychiatry 1992; 161: 633-7.CrossRefGoogle ScholarPubMed
[29]Theberge, JAl-Semaan, YDrost, DJMalla, AKNeufeld, RWBartha, R, et al. Duration of untreated psychosis vs. N-acetylaspartate and choline in first episode schizophrenia: a 1H magnetic resonance spectroscopy study at 4.0 tesla. Psychiatry Research 2004; 131: 107-14.Google ScholarPubMed
[30]Ucok, APolat, AGene, ACakir, STaran, N. Duration of untreated psychosis muy predict acute treatment response in first-episode schizophrenia. Journal of Psychiatry Research 2004; 38(2): 163-8.CrossRefGoogle Scholar
[31]Videbech, PRavnkilde, B. Hippocampal volume and depression. A metaanalysis of MRI studies. American Journal of Psychiatry 2004; 161: 1957-66.CrossRefGoogle ScholarPubMed
[32]Winokur, GCoryell, WKeller, MEndicott, JAkiskal, H. A prospective follow-up of patients with bipolar and primary unipolar affective disorder. Archives of General Psychiatry 1993; 50(6): 457-65.CrossRefGoogle ScholarPubMed
[33]Wyatt, RJ. Early intervention for schizophrenia. Can be the course of the illness be altered? Biological Psychiatry 1995; 38: 1–3.Google Scholar