TY  - JOUR
PY  - 2018//
TI  - Seeing the signs: using the course of residual depressive symptomatology to predict patterns of relapse and recurrence of major depressive disorder
JO  - Depression and anxiety
A1  - Verhoeven, Floor E. A.
A1  - Wardenaar, Klaas J.
A1  - Ruhé, Henricus G. Eric
A1  - Conradi, Henk-Jan
A1  - de Jonge, Peter
SP  - 148
EP  - 159
VL  - 35
IS  - 2
N2  - BACKGROUND: Major depressive disorder (MDD) is characterized by high relapse/recurrence rates. Predicting individual patients' relapse/recurrence risk has proven hard, possibly due to course heterogeneity among patients. This study aimed to (1) identify homogeneous data-driven subgroups with different patterns of relapse/recurrence and (2) identify associated predictors. <br><br>METHODS: For a year, we collected weekly depressive symptom ratings in 213 primary care MDD patients. Latent class growth analyses (LCGA), based on symptom-severity during the 24 weeks after no longer fulfilling criteria for the initial major depressive episode (MDE), were used to identify groups with different patterns of relapse/recurrence. Associations of baseline predictors with these groups were investigated, as were the groups' associations with 3- and 11-year follow-up depression outcomes. <br><br>RESULTS: LCGA showed that heterogeneity in relapse/recurrence after no longer fulfilling criteria for the initial MDE was best described by four classes: "quick symptom decline" (14.0%), "slow symptom decline" (23.3%), "steady residual symptoms" (38.7%), and "high residual symptoms" (24.1%). The latter two classes showed lower self-esteem at baseline, and more recurrences and higher severity at 3-year follow-up than the first two classes. Moreover, the high residual symptom class scored higher on neuroticism and lower on extraversion and self-esteem at baseline. Interestingly, the steady residual symptoms and high residual symptoms classes still showed higher severity of depressive symptoms after 11 years. <br><br>CONCLUSION: Some measures were associated with specific patterns of relapse/recurrence. Moreover, the data-driven relapse/recurrence groups were predictive of long-term outcomes, suggesting that patterns of residual symptoms could be of prognostic value in clinical practice.<br><br>© 2017 Wiley Periodicals, Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 1091-4269
UR  - http://dx.doi.org/10.1002/da.22695
ID  - ref1
ER  -