Time to recurrence after recovery from major depressive episodes and its predictors

2003 ◽  
Vol 33 (5) ◽  
pp. 839-845 ◽  
Author(s):  
T. KANAI ◽  
H. TAKEUCHI ◽  
T. A. FURUKAWA ◽  
R. YOSHIMURA ◽  
T. IMAIZUMI ◽  
...  
Keyword(s):  
Depressive Episode ◽  
Cumulative Probability ◽  
Residual Symptoms ◽  
Time To Recurrence ◽  
Recorded Data ◽  
Spectrum Of Patients ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Course Of Depression

Background. Depression is a remitting but recurring disease. However, there is a paucity of prospectively recorded data on the course of depression after recovery.Method. A multi-centre prospective serial follow-up study of an inception cohort of hitherto untreated unipolar major depression (N=95) for 6 years. We report the time to recurrence after recovery from the index depressive episode and their predictors.Results. The cumulative probability of remaining well without subthreshold symptoms was 57% (95% CI, 46 to 68%) at 1 year, 47% (95% CI, 36 to 58%) at 2 years and 35% (95% CI, 23 to 47%) at 5 years. The same without full relapse was 79% (95% CI, 70 to 88%) at 1 year, 70% (95% CI, 60 to 80%) at 2 years and 58% (95% CI, 46 to 70%) at 5 years. The median duration of well-interval from the end of the index episode to the beginning of the subthreshold episode was 19·0 months (95% CI, 2·4 to 35·7), and that to the end of the full episode was over 6 years. Residual symptoms at time of recovery predicted earlier recurrence.Conclusions. The median length of the well-interval was much longer than previously reported in studies employing similar definitions but dealing with a more severe spectrum of patients. However, the sobering fact remains that less than half of the patients can expect to remain virtually symptom-free for 2 years or more after recovery from the depressive episode.

scholarly journals Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study

2010 ◽  
Vol 41 (6) ◽  
pp. 1165-1174 ◽  
Author(s):  
H. J. Conradi ◽  
J. Ormel ◽  
P. de Jonge
Keyword(s):  
Prospective Study ◽  
Depressive Symptomatology ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Residual Symptoms ◽  
Full Remission ◽  
Sleeping Problems ◽  
The Individual ◽  
Major Depressive Episodes ◽  
Depressive Episodes

BackgroundResidual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular.MethodIn a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI).ResultsIn general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85–94% of the time during depressive episodes and 39–44% of the time during remissions.ConclusionsResidual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

Work stress as a risk factor for major depressive episode(s)

2004 ◽  
Vol 35 (6) ◽  
pp. 865-871 ◽  
Author(s):  
JIANLI WANG
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Major Depression ◽  
Work Stress ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Working Population ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background. Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.Method. Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n=6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994–1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996–1997 NPHS data.Results. The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7·1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio=2·35, 95% confidence interval 1·54–3·77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.Conclusions. Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive.

Comorbidity of Mood Disorders: A Longitudinal Prospective Study

1996 ◽  
Vol 168 (S30) ◽  
pp. 31-37 ◽  
Author(s):  
Jules Angst
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Panic Disorder ◽  
Generalised Anxiety Disorder ◽  
Major Depressive ◽  
Recurrent Brief Depression ◽  
Cannabis Consumption ◽  
Major Depressive Episodes ◽  
Depressive Episodes

From the Zurich cohort study (n=591), the association of major depressive episodes and recurrent brief depression (RBD) with other psychiatric disorders is presented cross-sectionally at age 28 and 30 years, and over ten years (age 20 to 30 years). Longitudinally, the odds ratios of major depression are highest with dysthymia (4.4), generalised anxiety disorder (4.4), panic disorder (2.7), hypomania and agoraphobia (2.6), and social phobia (2.4). There is a significant association with cannabis consumption and smoking. Follow-up data over nine years are available for 41 patients with a major depressive disorder (MDD) and 62 with RBD: approximately 20% of MDD patients did not receive a diagnosis during follow-up. Major depression reoccurred in 32%, became bipolar in 24%, or developed into RBD in 24%. RBD remitted in 41 %, reoccurred in 35%, turned into major depression in 22%, and became bipolar in only 7%. Longitudinally, MDD and RBD show a symmetrical diagnostic change in a quarter of the cases. There is no substantial development of MDD or RBD into minor depression or generalised anxiety disorder. Thirteen per cent of those with RBD later developed panic disorder.

scholarly journals Risk factors for new depressive episodes in primary health care: an international prospective 12-month follow-up study

2002 ◽  
Vol 32 (4) ◽  
pp. 595-607 ◽  
Author(s):  
K. BARKOW ◽  
W. MAIER ◽  
T. B. ÜSTÜN ◽  
M. GÄNSICKE ◽  
H.-U. WITTCHEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Depressive Episode ◽  
Icd 10 ◽  
Depressive Episodes ◽  
Psychiatric Problems

Background. Studies that examined community samples have reported several risk factors for the development of depressive episodes. The few studies that have been performed on primary care samples were mostly cross-sectional. Most samples had originated from highly developed industrial countries. This is the first study that prospectively investigates the risk factors of depressive episodes in an international primary care sample.Methods. A stratified primary care sample of initially non-depressed subjects (N = 2445) from 15 centres from all over the world was examined for the presence or absence of a depressive episode (ICD-10) at the 12 month follow-up assessment. The initial measures addressed sociodemographic variables, psychological/psychiatric problems and social disability. Logistic regression analysis was carried out to determine their relationship with the development of new depressive episodes.Results. At the 12-month follow-up, 4·4% of primary care patients met ICD-10 criteria for a depressive episode. Logistic regression analysis revealed that the recognition by the general practitioner as a psychiatric case, repeated suicidal thoughts, previous depressive episodes, the number of chronic organic diseases, poor general health, and a full or subthreshold ICD-10 disorder were related to the development of new depressive episodes.Conclusions. Psychological/psychiatric problems were found to play the most important role in the prediction of depressive episodes while sociodemographic variables were of lower importance. Differences compared with other studies might be due to our prospective design and possibly also to our culturally different sample. Applied stratification procedures, which resulted in a sample at high risk of developing depression, might be a limitation of our study.

Incidence and Predictors of Suicide Attempts in Bipolar I and II Disorders: A Five-year Follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. S87-S87
Author(s):  
S. Pallaskorpi ◽  
K. Suominen ◽  
M. Ketokivi ◽  
H. Valtonen ◽  
P. Arvilommi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Models ◽  
Suicide Attempts ◽  
Incidence Rates ◽  
Personality Factors ◽  
Long Term Study ◽  
Major Depressive Episodes ◽  
Depressive Episodes

IntroductionAlthough suicidal behavior is very common in bipolar disorder (BD), few long-term studies have investigated incidence and risk factors of suicide attempts (SAs) specifically related to illness phases of BD.ObjectivesWe examined incidence of SAs during different phases of BD in a long-term prospective cohort of bipolar I (BD-I) and II (BD-II) patients and risk factors specifically for SAs during major depressive episodes (MDEs).MethodsIn the Jorvi bipolar study (JoBS), 191 BD-I and BD-II patients were followed using life-chart methodology. Prospective information on SAs of 177 patients (92.7%) during different illness phases was available up to five years. Incidence of SAs and their predictors were investigated using logistic and Poisson regression models. Analyses of risk factors for SAs occurring during MDEs were conducted using two-level random-intercept logistic regression models.ResultsDuring the five-year follow-up, 90 SAs per 718 patient-years occurred. Compared with euthymia the incidence was highest, over 120-fold, during mixed states (765/1000 person-years [95% confidence interval (CI) 461–1269]) and also very high in MDEs, almost 60-fold (354/1000 [95%CI 277–451]). For risk of SAs during MDEs, the duration of MDEs, severity of depression and cluster C personality disorders were significant predictors.ConclusionsIn this long-term study, the highest incidences of SAs occurred in mixed phases and MDEs. The variations in incidence rates between euthymia and illness phases were remarkably large, suggesting that the question “when” rather than “who” may be more relevant for suicide risk in BD. However, risk during MDEs is likely also influenced by personality factors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Major depressive episode among university students in Southern Brazil

2020 ◽  
Vol 54 ◽  
pp. 11 ◽  
Author(s):  
Betina Daniele Flesch ◽  
Gbènankpon Mathias Houvèssou ◽  
Tiago Neuenfeld Munhoz ◽  
Anaclaudia Gastal Fassa
Keyword(s):  
University Students ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Negative Impact ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Southern Brazil ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

INTRODUCTION: Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS: A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS: A total of 32% (95% confidence interval 29.9–34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities’ sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION: In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students’ mental health promotion and care.

Who Becomes a Depressive Ruminator? Developmental Antecedents of Ruminative Response Style

2002 ◽  
Vol 16 (4) ◽  
pp. 405-419 ◽  
Author(s):  
Jelena Spasojević ◽  
Lauren B. Alloy
Keyword(s):  
College Freshmen ◽  
Response Style ◽  
Major Depressive ◽  
History Of Childhood ◽  
Developmental Factors ◽  
History Of ◽  
Developmental Antecedents ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Developmental antecedents of ruminative response style were examined in 137 college freshmen, who were followed prospectively for 2.5 years. Reports of mothers’ and fathers’ psychologically overcontrolling parenting as well as a history of childhood sexual (for women only) and emotional maltreatment were all related to ruminative response style. In addition, ruminative response style mediated the relationships between these developmental factors and the number of major depressive episodes experienced by participants during the follow-up period. Potential explanations and important implications of these findings are discussed.

Major Depressive Disorder: Recurrence Risk Factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S139-S139
Author(s):  
R. Ben Soussia ◽  
S. Khouadja ◽  
I. Marrag ◽  
S. Younes ◽  
M. Nasr
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Age At Onset ◽  
Recurrence Risk ◽  
University Hospital ◽  
Major Depressive ◽  
Residual Symptoms ◽  
Time To Recurrence ◽  
Depressive Episodes

IntroductionIn spite of the frequency and the gravity of the depressive episodes, the major depressive disorder (MDD) is diagnosed and treated today insufficiently and the risk factors of its recurrence are little approached.Aims of the studyDescribe the socio–demographic, clinical and therapeutic characteristics of patients with MDD and identify the factors involved in the recurrence risk.MethodologyThis is a retrospective study carried out in the university hospital of Mahdia, Tunisia during two years. We have included patients with a follow up for at least two years and diagnosed with MDD, isolated episode or MDD, recurrent episode according to the DSM-IV-TR criteria. Data collection was performed using two pre-established questionnaires respectively with 51 and 92 items. We have estimated the time to recurrence with the Kaplan-Meier estimator.ResultsWe have collected 150 patients. The time to recurrence was 109 months. Five factors were associated with recurrence: early age at onset of the disorder, family history of mood disorders, severity of the index major depressive episode, persistent residual symptoms and ceasing treatment.ConclusionDepression is a very common mental illness that is highly recurrent in individuals. There is great interest in the development of strategies that might reduce the recurrence of depression.

scholarly journals Negative Self-Referential Processing Predicts the Recurrence of Major Depressive Episodes

2016 ◽  
Vol 5 (1) ◽  
pp. 174-181 ◽  
Author(s):  
Joelle LeMoult ◽  
Katharina Kircanski ◽  
Gautam Prasad ◽  
Ian H. Gotlib
Keyword(s):  
Depressive Symptoms ◽  
Life Events ◽  
Depressive Episode ◽  
Negative Life Events ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Major Depressive ◽  
Referential Processing ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Most individuals who develop major depressive disorder (MDD) will experience a recurrent depressive episode; we know little, however, about cognitive mechanisms that increase the likelihood of recurrence. In the current study we examined whether negatively biased self-referential processing, negative life events, baseline depressive symptoms, and psychotropic medication use predicted the onset of a subsequent depressive episode in a longitudinal study of women with a history of recurrent MDD. Higher levels of depressive symptoms at baseline predicted experiencing a greater number of negative life events, which, in turn, tended to predict recurrence of depression. It is important that after accounting for other associations, negatively biased self-referential processing contributed unique variance to the likelihood of experiencing a depressive episode over the next 3 years. Thus, negatively biased self-referential processing appears to be a significant risk factor for the recurrence of depressive episodes and may be an important target for interventions aimed at preventing future episodes.

scholarly journals Does low coping efficacy mediate the association between negative life events and incident psychopathology? A prospective-longitudinal community study among adolescents and young adults

2015 ◽  
Vol 25 (2) ◽  
pp. 171-180 ◽  
Author(s):  
E. Asselmann ◽  
H.-U. Wittchen ◽  
R. Lieb ◽  
M. Höfler ◽  
K. Beesdo-Baum
Keyword(s):  
Substance Use ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Nicotine Dependence ◽  
Substance Use Disorder ◽  
Illicit Drugs ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Aims.To prospectively examine whether negative life events (NLE) and low perceived coping efficacy (CE) increase the risk for the onset of various forms of psychopathology and low CE mediates the associations between NLE and incident mental disorders.Methods.A representative community sample of adolescents and young adults (N = 3017, aged 14–24 at baseline) was prospectively followed up in up to three assessment waves over 10 years. Anxiety, depressive and substance use disorders were assessed at each wave using the DSM-IV/M-CIDI. NLE and CE were assessed at baseline with the Munich Event List and the Scale for Self-Control and Coping Skills. Associations (odds ratios, OR) of NLE and CE at baseline with incident mental disorders at follow-up were estimated using logistic regressions adjusted for sex and age.Results.NLE at baseline predicted the onset of any disorder, any anxiety disorder, panic disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.02–1.09 per one NLE more). When adjusting for any other lifetime disorder prior to baseline, merely the associations of NLE with any anxiety disorder, any depression, major depressive episodes, dysthymia and any substance use disorder remained significant (OR 1.02–1.07). Low CE at baseline predicted the onset of any disorder, any anxiety disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.16–1.72 per standard deviation). When adjusting for any other lifetime disorder prior to baseline, only the associations of low CE with any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs remained significant (OR 1.15–1.64). Low CE explained 9.46, 13.39, 12.65 and 17.31% of the associations between NLE and any disorder, any depression, major depressive episodes and dysthymia, respectively. When adjusting for any other lifetime disorder prior to baseline, the reductions in associations for any depression (9.77%) and major depressive episodes (9.40%) remained significant, while the reduction in association for dysthymia was attenuated to non-significance (p-value > 0.05).Conclusions.Our findings suggest that NLE and low perceived CE elevate the risk for various incident mental disorders and that low CE partially mediates the association between NLE and incident depression. Subjects with NLE might thus profit from targeted early interventions strengthening CE to prevent the onset of depression.

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