Persistent depressive disorder across the adult lifespan: results from clinical and population-based surveys in Germany

Nübel, Julia; Guhn, Anne; Müllender, Susanne; Le, Hong; Cohrdes, Caroline; Köhler, Stephan

doi:10.1186/s12888-020-2460-5

Cited by 23 publications

(19 citation statements)

References 64 publications

(80 reference statements)

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“…Findings suggest that about a third of all depressed patients develop a chronic form of depression (3,5,6). Compared to non-chronic forms of depression, PDD patients tend to have a significantly earlier onset and higher levels of treatment resistance (1,2,5).…”

Section: Introductionmentioning

confidence: 98%

“…PDD is defined by a duration of depressive symptoms for a minimum of 2 years and ranging in severity from dysthymia to chronic major depression [according to DSM-5, ( 4 )]. Findings suggest that about a third of all depressed patients develop a chronic form of depression ( 3 , 5 , 6 ). Compared to non-chronic forms of depression, PDD patients tend to have a significantly earlier onset and higher levels of treatment resistance ( 1 , 2 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Borderline Personality Features in Patients With Persistent Depressive Disorder and Their Effect on CBASP Outcome

et al. 2021

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Introduction: The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was developed for the treatment of persistent depressive disorder (PDD), where comorbid personality disorders (PD) are common. In contrast to other PD, comorbid borderline personality disorder (BPD) is often regarded as an exclusion criterion for CBASP. In clinical settings, however, subthreshold BPD symptoms are prevalent in PDD and may not be obvious at an initial assessment prior to therapy. As data on their impact on CBASP outcome are very limited, this naturalistic study investigates BPD features in PDD and their relevance for the therapeutic outcome of a multimodal CBASP inpatient program.Method: Sixty patients (37 female, mean age 38.3, SD 11.9 years) meeting DSM-5 criteria for PDD underwent a 10 weeks CBASP inpatient program. BPD features (i.e., number of fulfilled DSM-5 criteria) together with childhood maltreatment and rejection sensitivity were assessed on admission. Before and after treatment, severity of depressive symptoms was measured using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI-II). BPD symptoms were assessed using the Borderline Personality Disorder Severity Index (BPDSI-IV) and the Borderline Symptom List (BSL-23). Intercorrelations of baseline characteristics and symptom change during treatment were analyzed.Results: Patients with PDD met a mean of 1.5 (SD 1.6) BPD criteria with 4 patients fulfilling ≥5 criteria. BPD symptoms and depressive symptoms showed a strong correlation, and BPD symptoms were additionally correlated with emotional abuse and rejection sensitivity. There was no association between BPD features at baseline and improvement on the MADRS, however, BPD features tended to be associated with a lower response according to the BDI-II score after 10 weeks of treatment. Furthermore, BPD symptoms (i.e., abandonment, impulsivity and affective instability) were reduced after 10 weeks of CBASP treatment.Discussion: BPD symptoms are prevalent in patients with PDD and highly intertwined with the experience of depressive symptoms. In this naturalistic study in PDD, BPD features at baseline did not limit the clinical response to CBASP. Future studies may extend the spectrum of PDD to comorbid subsyndromal or even syndromal BPD in order to develop tailored psychotherapeutic treatment for these complex affective disorders.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Borderline Personality Features in Patients With Persistent Depressive Disorder and Their Effect on CBASP Outcome

et al. 2021

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“…As compared to the episodic form of depression, Persistent Depressive Disorder (PDD) is associated with stronger impairment in life and higher social and economic costs ( 23 ). Although it has often been hypothesized that a chronic course of depression may be explained by dysfunctional interpersonal patterns, there is a lack of research supporting this assumption.…”

Section: Introductionmentioning

confidence: 99%

Reduced Social Connectedness and Compassion Toward Close Others in Patients With Chronic Depression Compared to a Non-clinical Sample

et al. 2021

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Reduced social functioning in depression has been explained by different factors. Reduced social connectedness and prosocial motivation may contribute to interpersonal difficulties, particularly in chronic depression. In the present study, we tested whether social connectedness and prosocial motivation are reduced in chronic depression. Forty-seven patients with persistent depression and 49 healthy controls matched for age and gender completed the Inclusion of the Other in the Self Scale (IOS), the Compassionate Love Scale (CLS), the Beck Depression Inventory-II, and the Childhood Trauma Questionnaire. A Multivariate analysis of variance (MANOVA) with IOS and CLS as dependent variables revealed a highly significant difference between both groups. The IOS and the CLS-subscale Close Others were lower in persistent depression, whereas there was no difference in the CLS-subscale Strangers/Humanity. IOS and CLS-Close Others showed significant negative correlations with depressive symptoms. Connectedness to family members as measured by the IOS was negatively correlated with childhood trauma in patients with chronic depression. The results indicate that compassion and perceived social connection are reduced in depressed patients toward close others, but not to others in general. Implications for the treatment of depression are discussed.

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“…Depression is already known to follow distinct trajectories: The persistent depressive disorder must be distinguished from non-chronic major depression, which clearly differ in their course and therapeutic consequences [ 14 ]. However, little is known on symptom trajectories and associated factors of depressive symptoms following critical illness.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of depression in sepsis survivors: an observational cohort study

et al. 2021

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Background Advances in critical care medicine have led to a growing number of critical illness survivors. A considerable part of them suffers from long-term sequelae, also known as post-intensive care syndrome. Among these, depressive symptoms are frequently observed. Depressive symptom trajectories and associated factors of critical illness survivors have rarely been investigated. Study objective was to explore and compare different trajectories of depressive symptoms in sepsis survivors over 1 year after discharge from ICU. Methods Data of a randomized controlled trial on long-term post-sepsis care were analyzed post hoc. Depressive symptoms were collected at 1, 6 and 12 months post-ICU discharge using the Major Depression Inventory (MDI), among others. Statistical analyses comprised descriptive analysis, univariate and multivariate, linear and logistic regression models and Growth Mixture Modeling. Results A total of 224 patients were included into this analysis. We identified three latent classes of depressive symptom trajectories: Over the course of 1 year, 152 patients recovered from mild symptoms, 27 patients showed severe persistent symptoms, and 45 patients recovered from severe symptoms. MDI sum scores significantly differed between the three classes of depressive symptom trajectories at 1 and 6 months after ICU discharge (p < 0.024 and p < 0.001, respectively). Compared with other classes, patients with the mild recovered trajectory showed lower levels of chronic pain (median sum score of 43.3 vs. 60.0/53.3 on the Graded Chronic Pain Scale, p < 0.010) and posttraumatic stress (4.6% with a sum score of ≥ 35 on the Posttraumatic Stress Scale 10 vs. 48.1%/33.3%, p < 0.003); and higher levels of health-related quality of life (HRQOL) using the Short Form-36 scale within 1 month after ICU discharge (p < 0.035). Conclusions In the first year after discharge from ICU, sepsis survivors showed three different trajectories of depressive symptoms. Course and severity of depressive symptoms were associated with chronic pain, posttraumatic stress and reduced HRQOL at discharge from ICU. Regular screening of sepsis survivors on symptoms of depression, chronic pain and posttraumatic stress within 1 year after ICU may be considered. Trial registration ISRCTN, ISRCTN 61744782. Registered April 19, 2011—Retrospectively registered, http://www.isrctn.com/ISRCTN61744782.

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Persistent depressive disorder across the adult lifespan: results from clinical and population-based surveys in Germany

Cited by 23 publications

References 64 publications

Borderline Personality Features in Patients With Persistent Depressive Disorder and Their Effect on CBASP Outcome

Borderline Personality Features in Patients With Persistent Depressive Disorder and Their Effect on CBASP Outcome

Reduced Social Connectedness and Compassion Toward Close Others in Patients With Chronic Depression Compared to a Non-clinical Sample

Trajectories of depression in sepsis survivors: an observational cohort study

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