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Future Imperfect: the Long-Term Outcome of Depression

Published online by Cambridge University Press:  02 January 2018

P. G. Surtees  and
C. Barkley
P. G. Surtees*
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR
C. Barkley
Affiliation:
Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, now Prestwich Hospital, Bury New Road, Manchester N25 7BL
*
∗Correspondence
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Abstract

During 1976, 80 patients with a primary depressive illness were selected from a consecutive series of referrals to the Royal Edinburgh Hospital for a short-term follow-up study. This paper concerns the 12-year longitudinal assessment of the survivors. During the follow-up, mortality risk for the sample was almost doubled. Of the series, 35% had experienced a recurrence within 2 years of the initial interview, and just over 60% within the entire study time of 12 years. The risk of recurrence was enhanced for those aged over 45 years at index, for those with a history of depressive disorder and for those who had not engaged in parasuicidal behaviour during the index episode. The observed effect of previous episodes was largely accounted for by age. The chance of recurrence was not affected by whether the treatment of the index episode included ECT, or by whether diagnosis was ‘endogenous’ or ‘neurotic’. Application of the Lee-Murray outcome criteria showed that about one-third of the Edinburgh series experienced a very poor outcome. Results are presented concerning the prediction of long-term outcome as represented by the Depression Outcome Scale (DOS), a measure specially constructed for this study.

Type
Peer Review
Information
The British Journal of Psychiatry , Volume 164 , Issue 3 , March 1994 , pp. 327 - 341
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Anderson, E. W. (1936) Prognosis of depressions of later life. Journal of Mental Science, 82, 559–588.Google Scholar
Ashby, D., West, C. R. & Ames, D. (1989) The ordered logistic regression model in psychiatry: rising prevalence of dementia in old people's homes. Statistics in Medicine, 8, 1317–1326.Google Scholar
BMDP Statistical Software Manual Vol. 2 (1990) Berkeley: University of California Press.Google Scholar
Coryell, W., Endicott, J., & Keller, M. (1990) Outcome of patients with chronic affective-disorder - a 5-year follow-up. American Journal of Psychiatry, 147, 1627–1633.Google Scholar
Croft-Jeffreys, C. & Wilkinson, G. (1989) Estimated costs of neurotic disorder in UK general practice 1985. Psychological Medicine, 19, 549–558.Google Scholar
Duggan, C. F., Lee, A. S. & Murray, R. M. (1990) Does personality predict long-term outcome in depression? British Journal of Psychiatry, 157, 19–24.Google Scholar
Duggan, C. F., Lee, A. S. & Murray, R. M. (1991) Do different subtypes of hospitalized depressives have different long-term outcomes? Archives of General Psychiatry, 48, 308–312.Google Scholar
Lancet (1992) Depression and suicide: are they preventable? (Editorial) Lancet, 340, 700–701.Google Scholar
Eitinger, L. (1955) Studies in neuroses. Acta Psychiatrica Scandinavica (suppl. 101).Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L. & Cohen, J. (1976) The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.Google Scholar
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory. London: University of London Press.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Frank, E., Prien, R. F., Jarrett, R. B., et al (1991) Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Archives of General Psychiatry, 48, 851–855.Google Scholar
Glen, A. I. M., Johnson, A. L. & Shepherd, M. (1984) Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind, controlled trial. Psychological Medicine, 14, 37–50.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–61.Google Scholar
Keller, M. B., Shapiro, R. W., Lavori, P. W., et al (1982a) Recovery in major depressive disorder. Analysis with the life table and regression models. Archives of General Psychiatry, 39, 905–910.Google Scholar
Keller, M. B., Shapiro, R. W., Lavori, P. W., et al (1982b) Relapse in major depressive disorder. Analysis with the life table. Archives of General Psychiatry, 39, 911–915.Google Scholar
Keller, M. B., Shapiro, R. W., Rice, J., et al (1986) The persistent risk of chronicity in recurrent episodes of non-bipolar major depressive disorder: a prospective follow-up. American Journal of Psychiatry, 143, 24–28.Google Scholar
Keller, M. B., Shapiro, R. W., Friedman, B., et al (1987) The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548.Google Scholar
Keller, M. B., Shapiro, R. W., Mueller, T. I., et al (1992) Time to recovery, chronicity, and levels of psychopathology in major depression - a 5-year prospective follow-up of 431 subjects. Archives of General Psychiatry, 49, 809–816.Google Scholar
Kerr, T. A., Roth, M., Schapira, K., et al (1972) The assessment and prediction of outcome in affective disorders. British Journal of Psychiatry, 121, 167–174.Google Scholar
Kerr, T. A., Roth, M., Schapira, K., (1974) Prediction of outcome in anxiety states and depressive illnesses. British Journal of Psychiatry, 124, 125–133.Google Scholar
Kiloh, L. G., Andrews, G. & Neilson, M. (1988) The long-term outcome of depressive-illness. British Journal of Psychiatry, 153, 752–757.Google Scholar
Kiloh, L. G., Andrews, G. & Neilson, M. (1989) Australian depression. British Journal of Psychiatry, 155, 264.CrossRefGoogle ScholarPubMed
Kupfer, D. J., Frank, E., Perel, J. M., et al (1992) 5-year outcome for maintenance therapies in recurrent depression. Archives of General Psychiatry, 49, 769–773.Google Scholar
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741–751.Google Scholar
Lee, A. S. & Murray, R. M. (1989) Better to be depressed in Australia. British Journal of Psychiatry, 155, 123–124.Google Scholar
Lee, A. S. & Duggan, C. F. (1991) British and Australian depression revisited. British Journal of Psychiatry, 158, 287–288.Google Scholar
Lewis, A. J. (1934) Melancholia: a clinical survey of depressive states. Journal of Mental Science, 80, 277–378.Google Scholar
Lewis, A. J. (1936) Melancholia: a prognostic study. Journal of Mental Science, 82, 488–558.Google Scholar
Medical Research Council (1965) Report by clinical psychiatry committee. Clinical trial of the treatment of depressive illness. British Medical Journal, i, 881–886.Google Scholar
Mindham, R. H. S., Howland, C. & Shepherd, M. (1973) An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine, 3, 5–17.Google Scholar
Office of Population Censuses and Surveys (1970) Classification of Occupations, 1970. London: HMSO.Google Scholar
Prien, R. F., Carpenter, L. L. & Kupfer, D. J. (1991) The definition and operational criteria for treatment outcome of major depressive disorder. Archives of General Psychiatry, 48, 796–800.Google Scholar
Ramana, R. & Battersby, M. W. (1989) Better to be depressed in Australia … or not. British Journal of Psychiatry, 155, 124–125.Google Scholar
Regier, D. A., Boyd, J. H., Burke, J. D., et al (1988) One-month prevalence of mental disorders in the United States. Based on five epidemiologic catchment area sites. Archives of General Psychiatry, 45, 977–986.Google Scholar
Robins, E. & Guze, S. B. (1972) Classification of affective disorders: the primary-secondary, the endogenous-reactive, and the neurotic-psychotic concepts. In Recent Advances in Psychobiology of the Depressive Illnesses (Eds Williams, T. A., Katz, M. M. & Shields, G.), pp. 283–293. Washington DC: US Government Printing Office.Google Scholar
Roth, M., Gurney, C., Mountjoy, C. Q., et al (1976) The relationship between classification and response to drugs in affective disorders. In Symposium on Monoamine Oxidase and its Inhibition (eds Wolstenholme, G. E. W. & Knight, J.), pp. 297–325. Amsterdam: CIBA.Google Scholar
Scrips Yearbook (1993) 9th edn. Richmond, UK: PJB Publications.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
SPSS Reference Guide (1990) Chicago, USA.Google Scholar
Surtees, P. G. (1980) Social support, residual adversity and depressive outcome. Social Psychiatry, 15, 71–80.Google Scholar
Surtees, P. G. & Ingham, J. G. (1980) Life stress and depressive outcome: application of a dissipation model to life events. Social Psychiatry, 15, 21–31.Google Scholar
Wells, J. E., Bushnell, J. A., Hornblow, A. R., et al (1989) Christchurch Psychiatric Epidemiology Study, Part 1: Methodology and lifetime prevalence for specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry, 23, 315–326.Google Scholar
World Health Organization (1974) Glossary of Mental Disorders and Guide to their Classification. For Use in Conjunction with the International Classification of Diseases (8th revision). Geneva: World Health Organization.Google Scholar
Ziegler, L. H. & Heersema, P. H. (1942) A follow-up study of 111 non-hospitalised depressed patients after 14 years. American Journal of Psychiatry, 99, 813–817.Google Scholar
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