TY  - JOUR
PY  - 2001//
TI  - A 25-year longitudinal, comparison study of the outcome of depression
JO  - Psychological medicine
A1  - Brodaty, H.
A1  - Luscombe, G.
A1  - Peisah, C.
A1  - Anstey, K.
A1  - Andrews, G.
SP  - 1347
EP  - 1359
VL  - 31
IS  - 8
N2  - BACKGROUND: There is still a relative paucity of information about the long-term course of depression.  METHODS: Consecutive patients admitted to a teaching hospital psychiatry unit with symptoms of depression, previously assessed at 6 months and 2, 5 and 15 years after index admission, were reviewed at 25 years (N = 49, including eight informants of deceased probands, of an original 145 with major depression (DEPs)). Prospective psychiatric (N = 22) and retrospective surgical (N = 50) control groups assessed after 25 years were used for comparison.  RESULTS: A further decade of follow-up confirmed the chronicity of depression. Of depressed patients (DEPs) followed for the full 25-year-period only 12% of the 49 original DEPs recovered and remained continuously well, 84% experienced recurrences, 2% experienced an unremitting course and another 2% died by suicide. Note that in the first 15-year-period 6% (9/145 DEPs) committed suicide, a further 38 died and 32 were lost to follow-up. They experienced an average of three episodes of depression over the 25 years. In the decade since the 15-year follow-up, 27% improved in clinical outcome (including four of five previously chronically depressed patients), 55% remained unchanged and 18% worsened; and the number of episodes per year declined. Patients initially diagnosed with neurotic or endogenous depression had similar long-term outcomes. The criteria for a current DSM-III-R disorder were met by 37% of DEPs, including 11% with depression or dysthymia. On the global assessment of functioning scale 78% of the DEPs had some impairment compared to 62% of psychiatric controls and 40% of surgical controls.  CONCLUSION: Even after 25 years, severe depressive disorders appear to have poor long-term outcomes. Patients with chronic outcomes over 15 years can improve when followed over longer periods.<p /> <p>Language: en</p>
LA  - en
SN  - 0033-2917
UR  - http://dx.doi.org/10.1017/s0033291701004743
ID  - ref1
ER  -