Rorschach Variables and Dysfunctional Attitudes as Measures of Depressive Vulnerability: A 9-Year Follow-Up Study of Individuals With Different Histories of Major Depressive Episodes

2012 ◽  
Vol 95 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Ellen Hartmann ◽  
Marianne Halvorsen ◽  
Catharina E. A. Wang
Keyword(s):  
Dysfunctional Attitudes ◽  
Major Depressive ◽  
Follow Up Study ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Rorschach Variables ◽  
Depressive Vulnerability

scholarly journals Time to recovery of an inception cohort with hitherto untreated unipolar major depressive episodes

2000 ◽  
Vol 177 (4) ◽  
pp. 331-335 ◽  
Author(s):  
Toshiaki A. Furukawa ◽  
Toshinori Kitamura ◽  
Kiyohisa Takahashi
Keyword(s):  
Major Depression ◽  
Mood Disorder ◽  
Tertiary Care ◽  
Inception Cohort ◽  
Major Depressive ◽  
Follow Up Study ◽  
History Of ◽  
Major Depressive Episodes ◽  
Depressive Episodes

BackgroundGeneralisability of existing studies on the naturalistic history of major depression is undermined by overrepresentation of in-patients and tertiary care academic centres, inclusion of patients already on treatment and/or incomplete follow-up.AimsTo report the time to recovery of an inception cohort of unipolar major depressive episodes.MethodA multi-centre prospective follow-up study of patients with a mood disorder, who had been selected to be representative of the untreated first-visit patients at 23 psychiatric settings from all over Japan.ResultsThe median time to recovery of the index episode after treatment commencement was 3 months (95% CI 2.5–3.6): 26% of the cohort reached asymptomatic or minimally symptomatic status by I month, 63% by 3 months, 85% by 12 months and 88% by 24 months.ConclusionsOur estimate of the episode length was 25–50% shorter than estimates reported in the literature.

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.

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.

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.

Bipolar II illness: course and outcome over a five-year period

1989 ◽  
Vol 19 (1) ◽  
pp. 129-141 ◽  
Author(s):  
William Coryell ◽  
Martin Keller ◽  
Jean Endicott ◽  
Nancy Andreasen ◽  
Paula Clayton ◽  
...  
Keyword(s):  
Major Depression ◽  
Family Study ◽  
Study Data ◽  
Major Depressive ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Relapse Rates

SynopsisA five year semi-annual follow-up of patients with non-bipolar (N = 442), bipolar II (N = 64) and bipolar I (N = 53) major depression tracked the courses of prospectively observed major depressive, hypomanic and manic syndromes. In all three groups, depression was much more likely in any given week than was hypomania or mania. However, during the majority of weeks, no full syndrome was present and none of the groups exhibited evidence of continuing psychosocial deterioration. Though all three groups exhibited similar times to recovery from index and subsequent major depressive episodes, both bipolar groups had substantially higher relapse rates and developed more episodes of major depression, hypomania and mania. The two bipolar groups, in turn, differed by the severity of manic-like syndromes and thus remained diagnostically stable; the bipolar II patients were much less likely to develop full manic syndromes or to be hospitalized during follow-up. In conjunction with family study data showing that bipolar II disorder breeds true, these data support the separation of bipolar I and bipolar II affective disorder.

scholarly journals Maintenance Pharmacotherapy for Recurrent Major Depressive Disorder in Primary Care: A 5-year Follow-up Study

2017 ◽  
Vol 41 (1) ◽  
pp. 111-114 ◽  
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
E. Isometsä
Keyword(s):  
Primary Care ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Maintenance Treatment ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Recurrent Major Depressive Disorder ◽  
Major Depressive Episodes ◽  
Depressive Episodes

AbstractBackgroundMost practice guidelines recommend maintenance antidepressant treatment for recurrent major depressive disorder. However, the degree to which such guidance is actually followed in primary health care has remained obscure. We investigated the provision of maintenance antidepressant treatment within a representative primary care five-year cohort study.MethodsIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up. A graphic life chart enabling evaluation of the longitudinal course of episodes plus duration of pharmacotherapies was used. In accordance with national guidelines, an indication for maintenance treatment was defined to exist after three or more lifetime major depressive episodes (MDEs); maintenance treatment was to commence four months after onset of full remission.ResultsOf the cohort patients, 34% (46/137) had three or more lifetime MDEs, thus indicating the requirement for maintenance pharmacotherapy. Of these, half (54%, 25/46) received maintenance treatment, for only 29% (489/1670) of the months indicated.ConclusionsIn this cohort of depressed primary care patients, half of patients with indications for maintenance treatment actually received it, and only for a fraction of the time indicated. Antidepressant maintenance treatment for the prevention of recurrences is unlikely to be subject to large-scale actualization as recommended, which may significantly undermine the potential public health benefits of treatment.

What is the role of conventional antidepressants in the treatment of major depressive episodes with Mixed Features Specifier?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Gianni L. Faedda ◽  
Ciro Marangoni
Keyword(s):  
Clinical Trials ◽  
Unipolar Depression ◽  
Preliminary Evidence ◽  
Major Depressive ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Mixed Features ◽  
Effective Use ◽  
Major Depressive Episodes ◽  
Depressive Episodes

The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD).Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges. To understand the diagnostic context of DMX, we trace the nosological changes and collocation of intradepressive hypomanic symptoms, and examine diagnostic and prognostic implications of such mixed features.One of the reasons so little is known about the treatment of DMX is that depressed patients with rapid cycling, substance abuse disorder, and suicidal ideation/attempts are routinely excluded from clinical trials of antidepressants. The exclusion of DMX patients from clinical trials has prevented an assessment of the safety and tolerability of short- and long-term use of antidepressants. Therefore, the generalization of data obtained in clinical trials for unipolar depression to patients with intradepressive hypomanic features is inappropriate and methodologically flawed.A selective review of the literature shows that antidepressants alone have limited efficacy in DMX, but they have the potential to induce, maintain, or worsen mixed features during depressive episodes in BD. On the other hand, preliminary evidence supports the effective use of some atypical antipsychotics in the treatment of DMX.

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