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Severity of depressive episodes during the course of depressive disorder

  • Lars Vedel Kessing (a1)

Abstract

Background

It is not clear whether the severity of depressive episodes changes during the course of depressive disorder.

Aims

To investigate whether the severity of depressive episodes increases during the course of illness.

Method

Using a Danish nationwide case register, all psychiatric inpatients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994–2003.

Results

A total of 19 392 patients received a diagnosis of a single depressive episode at first contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact and calendar year.

Conclusions

The increasing severity of depressive episodes emphasises the importance of early and sustained prophylactic treatment.

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Copyright

References

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1 Kessing, LV, Andersen, PK, Mortensen, PB, Bolwig, TG. Recurrence in affective disorder. I. Case register study. Br J Psychiatry 1998; 172: 23–8.
2 Kessing, LV. Recurrence in affective disorder. II. Effect of age and gender. Br J Psychiatry 1998; 172: 2934.
3 Kessing, LV, Hansen, MG, Andersen, PK. Course of illness in depressive and bipolar disorders. Naturalistic study, 1994–1999. Br J Psychiatry 2004; 185: 372–7.
4 Kessing, LV, Olsen, EW, Andersen, PK. Recurrence in affective disorder: analyses with frailty models. Am J Epidemiol 1999; 149: 404–11.
5 Kessing, LV, Hansen, MG, Andersen, PK, Angst, J. The predictive effect of episodes on the risk of recurrence in depressive and bipolar disorders – a life-long perspective. Acta Psychiatr Scand 2004; 109: 339–44.
6 Solomon, DA, Keller, MB, Leon, AC, Mueller, TI, Lavori, PW, Shea, MT, Coryell, W, Warshaw, M, Turvey, C, Maser, JD, Endicott, J. Multiple recurrences of major depressive disorder. Am J Psychiatry 2000; 157: 229–33.
7 Kessing, LV, Andersen, PK. Predictive effects of previous episodes on the risk of recurrence in depressive and bipolar disorders. Curr Psychiatry Rep 2005; 7: 413–20.
8 Swift, HM. The prognosis of recurrent insanity of the manic depressive type. Am J Insanity 1907; 64: 311–26.
9 MacDonald, JB. Prognosis in manic-depressive insanity. J Nerv Ment Dis 1918; 47: 2030.
10 Kraepelin, E. Manic-Depressive Insanity and Paranoia. Livingstone, 1921.
11 Angst, J. Course of affective disorders. In Handbook of Biological Psychiatry. Part 5: Brain Mechanisms and Abnormal Behaviour (ed Sachar, EJ): 225–42. Marcel Dekker, 1981.
12 Coryell, W, Akiskal, HS, Leon, AC, Winokur, G, Maser, JD, Mueller, TI, Keller, MB. The time course of nonchronic major depressive disorder. Uniformity across episodes and samples. National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies. Arch Gen Psychiatry 1994; 51: 405–10.
13 Solomon, DA, Keller, MB, Leon, AC, Mueller, TI, Shea, MT, Warshaw, M, Maser, JD, Coryell, W, Endicott, J. Recovery from major depression. A 10-year prospective follow-up across multiple episodes. Arch Gen Psychiatry 1997; 54: 1001–6.
14 Kessing, LV, Mortensen, PB. Recovery from episodes during the course of affective disorder: a case-register study. Acta Psychiatr Scand 1999; 100: 279–87.
15 Lewinsohn, PM, Zeiss, AM, Duncan, EM. Probability of relapse after recovery from an episode of depression. J Abnorm Psychol 1989; 98: 107–16.
16 Maj, M, Veltro, F, Pirozzi, R, Lobrace, S, Magliano, L. Pattern of recurrence of illness after recovery from an episode of major depression: a prospective study. Am J Psychiatry 1992; 149: 795800.
17 Munk-Jorgensen, P, Mortensen, PB. The Danish Psychiatric Central Register. Dan Med Bull 1997; 44: 82–4.
18 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization, 1992.
19 Kessing, LV, Andersen, PK, Mortensen, PB. Predictors of recurrence in affective disorder. A case register study. J Affect Disord 1998; 49: 101–8.
20 Kessing, LV. Severity of depressive episodes according to ICD-10: prediction of risk of relapse and suicide. Br J Psychiatry 2004; 184: 153–6.
21 Post, RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 1992; 149: 9991010.
22 Duman, RS, Heninger, GR, Nestler, EJ. A molecular and cellular theory of depression. Arch Gen Psychiatry 1997; 54: 597606.
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Severity of depressive episodes during the course of depressive disorder

  • Lars Vedel Kessing (a1)

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Severity of depressive episodes during the course of depressive disorder

  • Lars Vedel Kessing (a1)
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