TY  - JOUR
PY  - 2014//
TI  - Three-Year long-term outcome of 458 naturalistically treated inpatients with major depressive episode: severe relapse rates and risk factors
JO  - European archives of psychiatry and clinical neuroscience
A1  - Seemüller, Florian
A1  - Meier, Sebastian
A1  - Obermeier, Michael
A1  - Musil, Richard
A1  - Bauer, Michael
A1  - Adli, Mazda
A1  - Kronmüller, Klaus
A1  - Holsboer, Florian
A1  - Brieger, Peter
A1  - Laux, Gerd
A1  - Bender, Wolfram
A1  - Heuser, Isabella
A1  - Zeiler, Joachim
A1  - Gaebel, Wolfgang
A1  - Riedel, Michael
A1  - Falkai, Peter
A1  - Moller, Hans-Jurgen
SP  - 567
EP  - 575
VL  - 264
IS  - 7
N2  - In randomized controlled trials, maintenance treatment for relapse prevention has been proven to be efficacious in patients responding in acute treatment, its efficacy in long-term outcome in "real-world patients" has yet to be proven. Three-year long-term data from a large naturalistic multisite follow-up were presented. Severe relapse was defined as suicide, severe suicide attempt, or rehospitalization. Next to relapse rates, possible risk factors including antidepressant medication were identified using univariate generalized log-rank tests and multivariate Cox proportional hazards model for time to severe relapse. Overall data of 458 patients were available for analysis. Of all patients, 155 (33.6 %) experienced at least one severe relapse during the 3-year follow-up. The following variables were associated with a shorter time to a severe relapse in univariate and multivariate analyses: multiple hospitalizations, presence of avoidant personality disorder, continuing antipsychotic medication, and no further antidepressant treatment. In comparison with other studies, the observed rate of severe relapse during 3-year period is rather low. This is one of the first reports demonstrating a beneficial effect of long-term antidepressant medication on severe relapse rates in naturalistic patients. Concomitant antipsychotic medication may be a proxy marker for treatment resistant and psychotic depression.<p /> <p>Language: en</p>
LA  - en
SN  - 0940-1334
UR  - http://dx.doi.org/10.1007/s00406-014-0495-7
ID  - ref1
ER  -