Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-22T17:15:50.141Z Has data issue: false hasContentIssue false
  • English
  • Français

One-year course of the first vs. multiple episodes of depression—Polish naturalistic study

Published online by Cambridge University Press:  16 April 2020

Janusz K. Rybakowski ,
Dorota Nawacka  and
Andrzej Kiejna
Janusz K. Rybakowski*
Affiliation:
Department of Adult Psychiatry, University of Medical Sciences, ul. Szpitalna 27/33, 60-572Poznan, Poland
Dorota Nawacka
Affiliation:
Servier-Polska, Warsaw, Poland
Andrzej Kiejna
Affiliation:
Department of Psychiatry, University Medical School, Wroclaw, Poland
*
*Corresponding author. E-mail address: [email protected] (J.K. Rybakowski).
Get access

Abstract

Purpose

The aim of the study was to compare a clinical course and treatment results of depression occurring as the first depressive episode, the second depressive episode or the third or further depressive episode. The study was 1-year, prospective, naturalistic observation made by Polish psychiatrists.

Methods

One-hundred and seventy-nine patients with the first depressive episode (group I), 170 patients with the second episode (group II) and 183 patients with the third or further episode of depression (group III) were compared. The main analysed variable was remission, defined as the score of ≤7 points on 17-item Hamilton depression rating scale (HDRS), after 6 and 12 months of observation.

Results

The groups of patients studied did not initially differ as to age, proportion of gender and intensity of depression. The percentages of remission after 6 months of observation in groups I.III were: 49%, 41% and 32%, and after 12 months 69%, 60% and 50%, respectively.

Conclusions.

The results obtained indicate that the course of subsequent depressive episodes is less favourable compared to the first depressive episode. The percentages of remission obtained in individual groups studied may have implications regarding duration of pharmacological treatment of depressive episode.

Keywords

DepressionPolish naturalistic studyHamilton depression rating scale (HDRS)Remission
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 5 , August 2004 , pp. 258 - 263
Copyright
Copyright © 2004 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, JThe course of affective disorders. Psychopathology 1986;19: 47–52.CrossRefGoogle ScholarPubMed
Ballenger, JCClinical guidelines for establishing remission in patients with depression and anxiety. J Clin Psychiatry 1999;60(Suppl 22):29–34.Google ScholarPubMed
Donoghue, JHylan, TRAntidepressant use in clinical practice: efficacy vs. effectiveness. Br J Psychiatry 2001;179(Suppl 42):s9–s17.CrossRefGoogle Scholar
Ferrier, INTreatment of major depression: is improvement enough? J Clin Psychiatry 1999;60(Suppl 6):10–4.Google Scholar
Frank, EPrien, RFJarrett, RBKeller, MBKupfer, DJLavori, PWet al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry 1991;48:851–5.Google ScholarPubMed
Geddes, JRCarney, SMDavies, CFurukawa, TAKupfer, DJFrank, Eet al. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 2001;361:653–61.Google Scholar
Hamilton, MA rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
Hoencamp, EHaffmans, PMGriens, AMHuijbrechts, IPHeycop ten Ham BF. A 3.5-year naturalistic follow-up study of depressed outpatients. J Affect Disord 2001;66:267–71.CrossRefGoogle Scholar
Judd, LLAkiskal, HSMaser, JDZeller, PJEndicott, JCoryell, Wet al. A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry 1998;55:694–700.CrossRefGoogle ScholarPubMed
Judd, LLAkiskal, HSMaser, JDZeller, PJEndicott, JCoryell, Wet al. Major depressive disorder: a prospective study of residual subthresh-old depressive symptoms as predictor of rapid relapse. J Affect Disord 1998;50:97–108.CrossRefGoogle ScholarPubMed
Kennedy, SMcIntyre, RFallu, ALam, RPharmacotherapy to sustain the fully remitted state. J Psychiatry Neurosci 2002;27:269–80.Google ScholarPubMed
Kupfer, DJFrank, EPerel, JMFive-year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1992;49:769–73.CrossRefGoogle ScholarPubMed
Lieberman, JASheitman, BBKinon, BJNeurochemical sensitization in the pathophysiology of schizophrenia: deficits and dysfunction in neuronal regulation and plasticity. Neuropsychopharmacology 1997;17:205–29.CrossRefGoogle ScholarPubMed
Murray, CJLopez, ADAlternative projections of mortality and disability by cause 1990–2020: global burden of disease study. Lancet 1997;349:1498–504.CrossRefGoogle ScholarPubMed
Paykel, ESContinuation and maintenance therapy in depression. Br Med Bull 2001;57:145–59.CrossRefGoogle ScholarPubMed
Paykel, ESRamana, RCooper, ZHayhurst, HKerr, JBarocka, AResidual symptoms after partial remission: an important outcome in depression. Psychol Med 1995;25:1171–80.CrossRefGoogle ScholarPubMed
Prien, RFKupfer, DJContinuation drug therapy for major depressive episodes: how long should it be maintained? Am J Psychiatry 1986;143:18–23.Google ScholarPubMed
Ramana, RPaykel, ESCooper, ZHayhurst, HSaxty, MSurtees, PGRemission and relapse in major depression: a 2-year prospective follow-up study. Psychol Med 1995;25:1161–70.CrossRefGoogle Scholar
Rybakowski, JKTwardowska, KThe dexamethasone/corticotrophin releasing hormone test in depression in unipolar and bipolar affective illness. J Psychiatr Res 1999;33:363–70.CrossRefGoogle Scholar
Shea, TLeon, AMueller, TSolomon, DAWarshaw, MGKeller, MBDoes major depression result in lasting personality change? Am J Psychiatry 1996;153:1404–10.Google ScholarPubMed
Solomon, DAKeller, MBLeon, ACMueller, TIShea, MTWarshaw, Met al. Recovery from major depression: a 10-year prospective follow-up across multiple episodes. Arch Gen Psychiatry 1997;54: 1001–6.Google ScholarPubMed
The World Health Report 2001. Mental health: new understanding, new hope. Geneva: World Health Organization,; 2001.Google Scholar
Weiss, SRPost, RMKindling: separate vs. shared mechanisms in affective disorders and epilepsy. Neuropsychobiology 1998;38:167–80.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.