Situational Depression: Validity of the Concept

SummaryThe validity of the concept of situational (i.e. reactive) depression as distinct from other major depressive subtypes is examined in terms of psychosocial stressors, personality features, current symptomatology, and clinical course and follow-up. Thirty-eight patients with a recent onset of situational major depressive disorder (i.e. the disorder developed after an event or in a situation the diagnostician deemed likely to have contributed to the episode at that time) were compared with 68 non-situational major depressive patients. These patients were participants in the clinical studies of the NIMH-Clinical Research Branch Collaborative Program on the Psychobiology of Depression. No significant differences between the two groups were found in the total number, content areas, or other categorizations of life events, experienced prior to onset. Some statistically significant differences in current symptomatology and in clinical course and follow-up measures were obtained, but there were none in personality traits. Implications of these results in relation to previously published reports are discussed and caution is recommended in the use of the term situational depression until more definitive data become available.

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Six-year longitudinal course and outcomes of subtypes of depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.153098 ◽

2016 ◽

Vol 208 (1) ◽

pp. 62-68 ◽

Cited By ~ 41

Author(s):

F. Lamers ◽

A. T. F. Beekman ◽

A. M. van Hemert ◽

R. A. Schoevers ◽

B. W. J. H. Penninx

Keyword(s):

Latent Class ◽

Clinical Course ◽

Depression And Anxiety ◽

Major Depressive ◽

Longitudinal Course ◽

Baseline Severity ◽

Depressive Subtypes ◽

Depression Subtypes ◽

Over Time

BackgroundClinical and aetiological heterogeneity have impeded our understanding of depression.AimsTo evaluate differences in psychiatric and somatic course between people with depression subtypes that differed clinically (severity) and aetiologically (melancholic v. atypical).MethodData from baseline, 2-, 4- and 6-year follow-up of The Netherlands Study of Depression and Anxiety were used, and included 600 controls and 648 people with major depressive disorder (subtypes: severe melancholic n = 308; severe atypical n = 167; moderate n = 173, established using latent class analysis).ResultsThose with the moderate subtype had a significantly better psychiatric clinical course than the severe melancholic and atypical subtype groups. Suicidal thoughts and anxiety persisted longer in those with the melancholic subtype. The atypical subtype group continued to have the highest body mass index and highest prevalence of metabolic syndrome during follow-up, although differences between groups became less pronounced over time.ConclusionsCourse trajectories of depressive subtypes mostly ran parallel to each other, with baseline severity being the most important differentiator in course between groups.

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Stability and transitions of depressive subtypes over a 2-year follow-up

Psychological Medicine ◽

10.1017/s0033291712000141 ◽

2012 ◽

Vol 42 (10) ◽

pp. 2083-2093 ◽

Cited By ~ 42

Author(s):

F. Lamers ◽

D. Rhebergen ◽

K. R. Merikangas ◽

P. de Jonge ◽

A. T. F. Beekman ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Overweight And Obesity ◽

Depression And Anxiety ◽

Major Depressive ◽

Transition Analysis ◽

Depressive Subtypes ◽

The Stability ◽

Time Point

BackgroundIdentifying depressive subtypes is an important tool in reducing the heterogeneity of major depressive disorder. However, few studies have examined the stability of putative subtypes of depression over time.MethodThe sample included 488 persons from the Netherlands Study of Depression and Anxiety (NESDA) who had major depressive disorder at baseline and at the 2-year follow-up assessment. A latent transition analysis (LTA) was applied to examine the stability of depressive subtypes across time-points. Differences in demographic, clinical, psychosocial and health correlates between subtypes were evaluated in a subsample of persons with stable subtypes.ResultsThree subtypes were identified at each time-point: a moderate subtype (prevalence T0 39%, T1 42%), a severe typical subtype (T0 30%, T1 25%), and a severe atypical subtype (T0 31%, T1 34%). The LTA showed 76% stability across the 2-year follow-up, with the greatest stability in the severe atypical class (79%). Analyses of correlates in the stable subtypes showed a predominance of women and more overweight and obesity in the severe atypical subtype, and a greater number of negative life events and higher neuroticism and functioning scores in the severe typical subtype.ConclusionsSubtypes of major depressive disorder were found to be stable across a 2-year follow-up and to have distinct determinants, supporting the notion that the identified subtypes are clinically meaningful.

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Coping Strategies in Male Patients under Treatment for Substance Use Disorders and/or Severe Mental Illness: Influence in Clinical Course at One-Year Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm8111972 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1972 ◽

Cited By ~ 2

Author(s):

Julia Marquez-Arrico ◽

Laura Río-Martínez ◽

José Navarro ◽

Gemma Prat ◽

Diego Forero ◽

...

Keyword(s):

Social Support ◽

Mental Illness ◽

Substance Use ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Coping Strategies ◽

Clinical Course ◽

Major Depressive ◽

One Year

Coping strategies have an impact on substance use disorders (SUD), relapses, and clinical variables, but knowledge on this area is scarce. We explored the coping strategies used during treatment in patients with dual diagnosis (DD), SUD, and severe mental illness (SMI), and the relation with clinical course and relapses at one-year follow-up. A sample of 223 patients was divided into three groups depending on diagnosis: DD (N = 80; SUD with comorbid schizophrenia or major depressive disorder), SUD only (N = 80), and SMI only (N = 63; schizophrenia or major depressive disorder). MANCOVA analyses reflected differences in self-criticism and problem avoidance, with a higher use of these in the DD and SUD groups. The coping strategies used differed depending on the presence/absence of a SUD, but not depending on psychiatric diagnosis. At one-year follow-up, social support was the only strategy that predicted the presence of relapses in DD patients with schizophrenia (positively), and in SMI patients with major depressive disorder (negatively). Thus, social support was associated with relapses, but the relationship was different depending on psychiatric diagnosis. Further studies should analyze the implications of social support as a coping strategy in different mental disorders, as well as its usefulness in individualized interventions.

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258. The Effect of Clinical Course on Longitudinal Changes in Hippocampal Volume: A 2-Year Follow-Up Study in Patients with Major Depressive Disorder

Biological Psychiatry ◽

10.1016/j.biopsych.2017.02.272 ◽

2017 ◽

Vol 81 (10) ◽

pp. S106

Author(s):

Katharina Dohm ◽

Dario Zaremba ◽

Ronny Redlich ◽

Dominik Grotegerd ◽

Udo Dannlowski

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Clinical Course ◽

Hippocampal Volume ◽

Major Depressive ◽

Longitudinal Changes ◽

Follow Up Study

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Three- to 5-year prospective follow-up of outcome in major depression

Psychological Medicine ◽

10.1017/s0033291797006466 ◽

1998 ◽

Vol 28 (3) ◽

pp. 731-735 ◽

Cited By ~ 84

Author(s):

L. VAN LONDEN ◽

R. P. G. MOLENAAR ◽

J. G. GOEKOOP ◽

A. H. ZWINDERMAN ◽

H. G. M. ROOIJMANS

Keyword(s):

Major Depression ◽

Partial Remission ◽

Psychomotor Retardation ◽

Major Depressive ◽

Residual Symptoms ◽

Full Remission ◽

Depressive Episodes ◽

Depressive Patients ◽

Dutch Cohort

Background. A Dutch cohort of predominantly out-patient DSM-III-R major depressive patients was followed for 3 to 5 years after start of treatment in a psycho-neuro-endocrinological prediction study. The study design permitted description of the course of remissions, relapses and recurrences.Methods. Pharmacological treatment was standardized, psychotherapy was tailored to the needs of the patient, follow-ups were done monthly until 3 years or more after the initial recruitment.Results. After 9 months 49% of the patients had reached full remission and 45% were in partial remission. During the following 3 to 5 years 82% of the patients had reached a period of full remission. Sixteen per cent of the patients needed 2 years or more before full remission. A relapse or recurrence rate of 41% within 5 years was found. Patients with residual symptoms relapsed particularly in the first 4 months after remission, while patients without residual symptoms recurred mainly after 12 months after remission. Previous depressive episodes and psychoticism predicted relapse. Psychomotor retardation at inception predicted a longer time to partial remission.Conclusion. In most cases, major depression is a seriously impairing episodic disease. This is also true for a sample of predominantly out-patients treated at a university clinic.

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White Matter Hyperintensities after Five-Year Follow-Up and a Cross-Sectional FA Decrease in Bipolar I and Major Depressive Patients

Neuropsychobiology ◽

10.1159/000516234 ◽

2021 ◽

pp. 1-12

Author(s):

Tuula Kieseppä ◽

Riitta Mäntylä ◽

Katariina Luoma ◽

Eva Rikandi ◽

Pekka Jylhä ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Major Depressive ◽

Cross Sectional ◽

Clinical Variables ◽

Brain White Matter ◽

The Right ◽

Depressive Patients ◽

Fractional Anisotrophy

Introduction: An increase in brain white matter hyperintensities (WMHs) and a decrease in white matter fractional anisotrophy (FA) have been detected in bipolar I (BPI), II (BPII), and major depressive disorder (MDD) patients. Their relationship, and differences in diagnostic groups are obscure. Longitudinal studies are rare. Objective: After 5-year follow-up, we evaluated WMHs in BPI, BPII, and MDD patients as compared with controls, and studied the effects of clinical variables. We also explored the associations of clinical variables with cross-sectional whole brain FA. Methods: Eight BPI, 8 BPII, 6 MDD patients, and 19 controls participated in magnetic resonance imaging at baseline and follow-up. Diffusion weighted imaging was included at follow-up. WMHs were rated by the Coffey scale, and a tract-based spatial statistics method was used for diffusion data. The general linear model, ANOVA, Fisher’s exact, Wilcoxon sign, and Kruskal-Wallis tests were used for statistical analyses. Results: Periventricular WMHs were increased in BPI patients (p = 0.047) and associated with the duration of disorder and lifetime occurrence of substance use disorder (p = 0.018). FA decrease was found in the corpus callosum of BPI patients (p < 0.01). MDD patients showed FA decrease in the right cerebellar middle peduncle (RCMP) (p < 0.01). In BPI patients, the duration of disorder associated with FA increase in RCMP (p < 0.05). No FA decrease was detected in patients with WMHs as compared with those without. Conclusions: Preceding illness burden associated modestly with WMHs, and FA increase in RCMP in BPI patients. MDD patients had FA decrease in RCMP. No association with FA decrease and WMHs was found.

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