Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

Have, Margreet ten; Graaf, Ron de; Dorsselaer, Saskia van; Tuithof, Marlous; Kleinjan, Marloes; Penninx, Brenda W. J. H.

doi:10.1111/acps.12874

Cited by 79 publications

(59 citation statements)

References 43 publications

(117 reference statements)

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“…transition to other symptom episode, frequently called episode relapse) was found to be quite high ( P = 0.328) as well, but also repeated remission ( P = 0.404, after a new episode; and P = 0.148, after a chronic episode, that is an episode persistence status). In this sense, some authors state that recurrence after remission is the rule, with an estimated prevalence rate of recurrence up to 40% . We found a point prevalence of 4.38% of showing another episode after having had a first symptom episode with overall remission length of 3.67 years (SD = 1.12) until relapse.…”

Section: Discussionsupporting

confidence: 49%

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Torre‐Luque

Sánchez-Niubò

et al. 2019

Acta Psychiatr Scand

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Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study de la Torre-Luque A, de la Fuente J, Sanchez-Niubo A, et al. Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study.Aims: To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. Methods: Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health -Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. Results: Almost 85% of participants showed no depression, but prevalence became lower over time (B = À0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). Conclusions: The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence. Significant outcomes• Most of older adults did not show any episode of clinically relevant symptoms of depression over time.• Almost one in four older individuals who showed a first episode of symptoms showed either episode persistence or episode recurrence later in life.• Loneliness was the most relevant factor in predicting symptom episode emergence and persistence. Limitations• This is an epidemiological study focused on providing a coarse-grained picture of late-life depression symptom dynamics.• Despite our large sample from multiple countries across the globe, cultural issues were not controlled in this study.

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Section: Discussionsupporting

confidence: 49%

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Torre‐Luque

Sánchez-Niubò

et al. 2019

Acta Psychiatr Scand

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“…Depression affects 322 million people worldwide [4] and is the third-leading cause of years lived with a disability [5]. In 2010 alone it generated an estimated economic cost of 210.5 billion dollars when direct and indirect costs are included [6]. In addition, the disorder is recurrent and chronic [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial

Vázquez

López

Torres

et al. 2020

IJERPH

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Effective and accessible interventions for indicated prevention of depression are necessary and lacking, especially for informal caregivers. Although telephone-based interventions could increase the accessibility for caregivers, randomized controlled trials are scarce, with no examination of prevention to date. Moreover, the efficacy of specific therapeutic components in preventive cognitive-behavioral programs is unknown. The main objective of this study was to evaluate the efficacy of a telephone-administered psychological preventive intervention in informal caregivers with high depressive symptoms. A total of 219 caregivers were randomized to a cognitive-behavioral conference call intervention (CBCC, n = 69), a behavioral-activation conference call intervention (BACC, n = 70), or a usual care control group (CG, n = 80). Both interventions consisted of five 90-minute group sessions. At the post-intervention, incidence of depression was lower in CBCC and BACC compared to CG (1.5% and 1.4% vs. 8.8%). Relative risk was 0.17 for the CBCC and 0.16 for the BACC, and the number-needed-to-treat was 14 in both groups. Depressive symptoms were significantly lower in BACC and BACC groups compared to CG (d = 1.16 and 1.29), with no significant differences between CBCC and BACC groups. The conference call intervention was effective in preventing depression and the behavioral-activation component (BACC) was comparable to the CBCC intervention.

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“…The median duration of the depressive episodes found in the previous research ranged from 1 month to 6 months [14][15][16]. This could be an essential period of time when there is a need to be focused on assessing suicide risk and to provide intensive intervention to prevent suicidal behaviors.…”

Section: Introductionmentioning

confidence: 91%

“…1) The Beck Depression Inventory-II (BDI-II) Thai version, a widely used questionnaire for assessment of the severity of depression, was developed from its original version in English [18] and consists of 21 questions with a total score of 63. The severities of depression were categorized into minimal (0-13), mild (14)(15)(16)(17)(18)(19), moderate (20)(21)(22)(23)(24)(25)(26)(27)(28) and severe depression . The test showed good internal consistency (Cronbach's alpha coefficient, α = 0.91) and the Spearman's correlation coefficient, which indicated the relationship between the score obtained from this BDI-II and the Hamilton Rating Scale for Depression, was 0.71.…”

Section: Assessmentmentioning

confidence: 99%

Suicidality and associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorder: a cross-sectional study

Chiddaycha

Lueboonthavatchai²

2020

Preprint

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Background Some depressed people die by suicide although they are in treatment. The aims of this study were to examine the prevalence of suicidality and to identify the associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorders.Patients and methods A sample of 178 in- and outpatients with depressive disorders who were treated within the six-month period of being diagnosed or of a recurrent episode were recruited from a tertiary hospital during November 2017 to April 2018. The associations between suicide risks assessed using the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and various factors including demographic data, depressive severity, interpersonal problems, social support, family relationships, and life stress events were analyzed by chi-square test. Logistic regression was used for identification of the potential predictors of moderate-to-high suicide risk.Results Most of the subjects were single (80.9%), female (68%), and in early adulthood (mean age 28.9, SD 11.2). The prevalence of suicidal ideation, suicide attempt within one month, and previous history of suicide attempt during lifetime were 62.4%, 35.4% and 41%, respectively. The prevalence of suicidality (76.4%) and moderate-to-high suicide risk (48.4%) were high. The factors associated with moderate-to-high suicide risk were lower age, no religion, unemployment, history of substance use within one year, moderate-to-severe level of depression, being an in-patient, short duration of treatment, receiving benzodiazepines, having interpersonal role disputes, having interpersonal deficits, low social support, poor family relationships and functioning, and high severity level of health stress events. Potential predictors of moderate-to-high suicide risk were moderate-to-severe levels of depression, poor family relationships and functioning, age of 20 or lower, being an in-patient, and receiving benzodiazepines.Conclusion The prevalence of suicidality in patients with acutely treated depressive disorder was found to be high. Depressive severity and social factors such as poor family relationships were highly associated with suicide risk. Knowledge of these factors may raise awareness of suicide prevention during the course of treatment of depression.

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Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

Abstract: These risk indicators may help to identify patients requiring monitoring and who could benefit from preventive interventions or maintenance treatment.

Cited by 79 publications

References 43 publications

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial

Suicidality and associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorder: a cross-sectional study

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