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Historical Overview of Outcome of Depression

Published online by Cambridge University Press:  06 August 2018

Eugene S. Paykel*
Affiliation:
University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK

Abstract

Kraepelin established manic–depressive disorder on the psychiatric map as a remitting but recurrent disorder. As the concept of affective disorder became broader, its potentially chronic nature was also recognised in long-term follow-up studies. However, the advent of antidepressants in the late 1950s gave rise to more therapeutic optimism, and a tendency to regard unremitting and chronic features as reflecting characterological rather than affective disorders. In the late 1970s, an era of reappraisal started, and it is now clear from long-term follow-up studies that recurrence is common and chronicity occurs, although probably in a smaller proportion than previously. The wheel has come full circle recently in Britain, as the Department of Health and the Medical Research Council have established relapse and chronicity in depression as major health service research priorities.

Type
Research Article
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Astrup, C., Fossum, A. & Holmboe, R. (1959) A follow-up study of 270 patients with acute affective psychosis. Acta Psychiatrica et Neurologica Scandinavica, 135 (suppl.), 165.Google Scholar
Berti Ceroni, G., Neri, C. & Pezzoli, A. (1984) Chronicity in major depression – a naturalistic prospective study. Journal of Affective Disorders, 7, 123132.Google Scholar
Bratfos, O. & Haug, J. O. (1968) The course of manic–depressive psychosis. A follow-up investigation of 215 patients. Acta Psychiatrica Scandinavica, 44, 89112.CrossRefGoogle ScholarPubMed
Coryell, W., Endicott, J. & Keller, M. (1990) Outcome of patients with chronic affective disorder: a five-year follow-up. American Journal of Psychiatry, 147, 16271633.Google Scholar
Huston, P. E. & Locher, L. M. (1948) Involutional psychosis, course when untreated and when treated with electric shock. Archives of Neurology and Psychiatry, 59, 385394.CrossRefGoogle ScholarPubMed
Keller, M. B., Shapiro, R. W., Lavori, P. W., et al (1982a) Recovery in major depressive disorder: analysis with the life table and regression models. Archives of General Psychiatry, 39, 905910.Google Scholar
Keller, M. B., Shapiro, R. W., Lavori, P. W., et al (1982b) Relapse in major depressive disorder: analysis with the life table. Archives of General Psychiatry, 39, 911915.CrossRefGoogle ScholarPubMed
Keller, M. B., Klerman, G. L., Lavori, P. W., et al (1982c) Treatment received by depressed patients. Journal of the American Medical Association, 248, 18481855.Google Scholar
Keller, M. B., Klerman, G. L., Lavori, P. W., et al (1984) Long-term outcome of episodes of major depression. Clinical and public health significance. Journal of the American Medical Association, 252, 788792.Google Scholar
Keller, M. B., Lavori, W., Rice, J., et al (1986) The persistent risk of chronicity in recurrent episodes of nonbipolar major depressive disorder: a prospective follow-up. American Journal of Psychiatry, 143, 2428.Google ScholarPubMed
Kiloh, L. G., Andrews, G. & Neilson, M. (1988) The long-term outcome of depressive illness. British Journal of Psychiatry, 153, 752757.CrossRefGoogle ScholarPubMed
Klerman, G. L., Dimascio, A., Weissman, M., et al (1974) Treatment of depression by drugs and psychotherapy. American Journal of Psychiatry, 131, 186191.CrossRefGoogle ScholarPubMed
Kraepelin, E. (1921) Manic–Depressive Insanity and Paranoia (trans. Johnstone, T.). London: Ballière Tindall & Cox.CrossRefGoogle Scholar
Kupfer, D. J., Frank, E., Perel, J. M., et al (1992) Five-year outcome for maintenance therapies in recurrent depression. Archives of General Psychiatry, 49, 769773.CrossRefGoogle ScholarPubMed
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741751.Google Scholar
Lehmann, H. E., Fenton, F. R., Deutsch, M., et al (1988) An 11-year follow-up study of 110 depressed patients. Acta Psychiatrica Scandinavica, 78, 5765.CrossRefGoogle ScholarPubMed
Lundquist, G. (1945) Prognosis and course of manic–depressive psychoses. A follow-up study of 319 first admissions. Acta Scandinavica Psychiatrica et Neurologica, 35 (suppl), 196.Google Scholar
Paykel, E. S. (1993) The place of antidepressants in long-term treatment. In Psychopharmacology of Depression (eds Montgomery, S. A. & Corn, J. H.), pp. 218239. Oxford: Oxford University Press.Google Scholar
Paykel, E. S., Dimascio, A., Haskell, D., et al (1975) Effects of maintenance amitriptyline and psychotherapy on symptoms of depression. Psychological Medicine, 5, 6777.Google Scholar
Robins, E. & Guze, S. (1972) Classification of affective disorders – the primary–secondary, the endogenous–reactive, and the neurotic–psychotic dichotomies. In Recent Advances in Psychobiology of the Depressive Illnesses (eds Williams, T. A., Katz, M. M. & Shields, J. A.), pp. 283293. Washington, DC: US Printing Office.Google Scholar
Scott, J. (1988) Chronic depression. British Journal of Psychiatry, 153, 287297.CrossRefGoogle ScholarPubMed
Stendstedt, A. (1952) A study in manic–depressive psychosis. Clinical, social, and genetic investigations. Acta Psychiatrica et Neurologica Scandinavica, 79, 1111.Google Scholar
Taschev, T. (1974) The course and prognosis of depression on the basis of 652 patients deceased. In Classification and Prediction of Outcome of Depression (ed. Angst, J.). Stuttgart: Schattauer.Google Scholar
Weissman, M. M., Prusoff, B. A. & Klerman, G. L. (1978) Personality and the prediction of long-term outcome of depression. American Journal of Psychiatry, 135, 797800.Google ScholarPubMed
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