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Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study

Published online by Cambridge University Press:  08 October 2010

H. J. Conradi ,
J. Ormel  and
P. de Jonge
H. J. Conradi*
Affiliation:
Interdisciplinary Center for Psychiatric Epidemiology (ICPE), Department of Psychiatry, University Medical Center Groningen/University of Groningen, The Netherlands Department of Clinical Psychology, University of Amsterdam, The Netherlands
J. Ormel
Affiliation:
Interdisciplinary Center for Psychiatric Epidemiology (ICPE), Department of Psychiatry, University Medical Center Groningen/University of Groningen, The Netherlands
P. de Jonge
Affiliation:
Interdisciplinary Center for Psychiatric Epidemiology (ICPE), Department of Psychiatry, University Medical Center Groningen/University of Groningen, The Netherlands Department of Internal Medicine, University Medical Center Groningen, University of Groningen, The Netherlands Center of Research on Psychology and Somatic Disease (CORPS), Department of Medical Psychology, Tilburg University, The Netherlands
*
*Address for correspondence: H. J. Conradi, Ph.D., Department of Psychiatry, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. (Email: h.j.conradi@med.umcg.nl)
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Abstract

Background

Residual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular.

Method

In a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI).

Results

In general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85–94% of the time during depressive episodes and 39–44% of the time during remissions.

Conclusions

Residual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

Keywords

Depressionprimary careprospective studyresidual depressive symptomssymptom profiles
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1165 - 1174
Copyright
Copyright © Cambridge University Press 2010

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