Predictors of relapse into major depressive disorder in a nonclinical population

Article Abstract:

The natural history of major depression has been studied, but the data tends to be biased in several ways. First, subjects tend to be those who have sought treatment and who have experienced recurrent illness. In addition, relapse studies, however long-term, are always biased towards relapse that occurs sooner rather than later. Nevertheless, relative youth and a history of noneffective mental illness has been associated with risk of major depressive episodes. To control for some of these biases, the relatives and the spouses of patients with affective disorders, along with matched comparison subjects, were studied and re-interviewed six years later. Of the 596 subjects, 396 had a history of major depression, and 200 had a history of major depression and a nonaffective disorder. During the six-year-period, 33.8 percent of those with major depression only prior to the study experienced another episode of major depression; 23.5 percent were particularly serious. Of the group with major depression and a history of another, nonaffective, disorder prior to the study, 11.8 percent had a major depressive episode during the six-year study period; 8.2 percent were considered particularly devastating cases. Rates of relapse were lower for men than for women, at 25.5 percent versus 36.4 percent, respectively. Age was significant as well; 44.4 percent of those under age 40 relapsed compared with only 21.4 percent of those over 40 years old. History of multiple episodes did not make an individual more likely to relapse during this period. Other risk factors were the number of symptoms recalled from a previous episode of major depression and mild depression at intake. Therefore, relative youth and a history of nonaffective mental illness emerged as risk factors for the recurrence of depression in this sample, which confirms data from other studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Psychiatry, Longitudinal studies

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Outcome of patients with chronic affective disorder: a five-year follow-up

Article Abstract:

Patients with a chronic affective (mood) disorder who were treated at one of five large medical centers were involved in this study. Because of the wide range of outcomes from this type of disorder, which can include rapid improvement or continued and lengthy deterioration, the five-year outcomes of these patients were examined with attention to prognostic indicators. Within the group of 129 patients who had been diagnosed with a chronic affective disorder two or more years before the study began, the diseases included major depression, mania, or schizoaffective disorder. These subjects were followed for five years, along with 580 patients with similar diagnoses, but who had been ill for a shorter period of time when the study began. A variety of psychometric tests were performed and a number of characteristics of the subjects were assessed. At the end of the five-year period, 75 percent of the chronic patients experienced a recovery period which lasted for at least eight weeks. However, only about one third remained well for a six-month period, which indicates that chances of sustained remission for these patients are not good. These patients experienced recovery period later in the course of the follow-up, and 25 percent of the chronic patients still experienced no periods of recovery over five years. The most significant feature that was identified for the prognosis of these patients was the level of functioning five years prior to treatment. Individuals who were unable to function well within this time period had generally poorer outcomes. Other predictors of poor outcome included severe illness at time of treatment, and psychotic features. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Schizoaffective disorders, Schizoaffective disorder

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Bipolar affective disorder and high achievement: a familial association

Article Abstract:

Previous research has suggested links between affective disorders and high socioeconomic status and achievement levels, but most of these studies were conducted prior to the definition and subsequent separation of bipolar and nonbipolar depressions. To examine the relationship between socioeconomic status and affective disorder (depression or manic depression), a study was conducted of 594 subjects suffering from depressive disorders. The subjects were examined and divided into three subgroups: 442 were diagnosed with nonbipolar depression, that is, depression without manic depressive episodes; 88 had bipolar type I disorder, characterized by manic episodes; and 64 suffered from bipolar II, or hypomanic, disorder, characterized by less severe manic episodes accompanied by irritability. The two groups containing patients with bipolar disorders were found to have first-degree relatives with significantly higher levels of achievement than the first-degree relatives of the nonbipolar subjects. This was observed among those relatives who themselves had a bipolar illness and those who did not. These results suggest that there exists an indirect link between high achievement and bipolar disorders but not affective disorders in general. The factors that influence this phenomenon are as yet unknown and further research into the nature of this connection is needed.

Social aspects, Research, Case studies, Affective disorders, Mood disorders, Bipolar disorder

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