Severity and Comorbidity Predict Episode Duration and Recurrence of DSM-IV Major Depressive Disorder

Melartin, Tarja; Rytsälä, Heikki; Leskelä, Ulla; Lestelä-Mielonen, Paula; Sokero, T Petteri; Isometsä, Erkki

doi:10.4088/jcp.v65n0612

Cited by 142 publications

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“…This particular sample might explain the prevalence of the suicide item in the second component as well as its presence in the third component with sleep disturbances. The correlation between Factor 1 and the number of episodes is congruent with the literature that links the severity of depression with recurrence risk (Melartin et al, 2004). These results suggest that the higher the number of episodes, the more severe is the depression, or reciprocally, the more severe the depression, the higher is the recurrence.…”

Section: Tablesupporting

confidence: 79%

Is it valid to measure suicidal ideation by depression rating scales?

Desseilles

Perroud

Guillaume

et al. 2012

Journal of Affective Disorders

163

115

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Objective: To date, most researchers rely on suicidal items of scales primarily designed to measure depression severity to capture suicidal ideation (SI). This study aims at investigating how well the suicide item of the clinician rated Hamilton Scale for Depression (HAM-D) and principal factors derived from this scale correlate with SI scores derived from a well validated measure of SI: the Beck's scale for SI (SSI). Method: 281 suicide attempters consecutively hospitalized between 2007 and 2009 were assessed by using the SSI, the HAM-D and the self-report Beck Depression Inventory (BDI). Principal Component Analysis (PCA) was computed to extract main factors. Correlations between these factors, BDI's and HAM-D's suicide items and the SSI scores were then computed. Results: Three components were derived from the PCA. Factor 2 showed a major loading for the HAM-D suicide item. Both the HAM-D suicide item and Factor 2 positively correlated with the SSI total score (both p b 0.00001). Moreover, the BDI suicide item highly correlated with the Factor 2 (p b 0.001) and the SSI total score (p b 0.00001). Finally, the HAM-D suicide item correlated significantly with the number of suicide attempts (p = 0.0001) and the age at the first attempt (p = 0.002). Limitations: Our sample was heterogeneous and future studies should refine the taxonomy of the suicidal behavior in specific sub-populations. The study design was cross-sectional and replication in a prospective study is needed. Conclusion: These findings suggest that the use of a single suicide item or a dimensional factor derived from a depression scale might be a valid approach to assess the suicidal ideations. Moreover, the results suggest that clinician rated scales as well as self-report questionnaires are equally valid to do so.

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Section: Tablesupporting

confidence: 79%

Is it valid to measure suicidal ideation by depression rating scales?

Desseilles

Perroud

Guillaume

et al. 2012

Journal of Affective Disorders

163

115

View full text Add to dashboard Cite

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“…Patients who could not be not followed up did not differ significantly from the patients who were, in terms of suicide attempts before the index episode (18% vs. 14%), suicide attempt during the index episode (25% vs. 23%), or suicidal ideation (38% vs. 39%). However, they were somewhat younger, were more often living alone, had a higher score on the EPI-neuroticism scale, and more often had a comorbid dysthymia (Melartin et al, 2004).…”

Section: Suicide Attempts During the Follow-up Periodmentioning

confidence: 99%

“…Longer duration and greater severity of MDD are related to the referral to health services and psychiatric care. The severity of the depression and longer duration of MDE before treatment predict a longer episode of MDE (Melartin et al, 2004).…”

Section: Course and Outcome Of Mddmentioning

confidence: 99%

“…Of the 269 subjects with current MDD initially included in the study, 198 were still alive at the end of the 18-month follow-up period, had remained unipolar and could be followed up (Melartin et al, 2004). The patients whose diagnosis switched to bipolar disorder during the follow-up (13/269, [5%]) were analysed separately.…”

Section: Follow-up Procedures 441 Outcome Measures and Life-chart Mementioning

confidence: 99%

“…Two alternative definitions for duration of the index episode were used: the uninterrupted duration of the episode of major depressive episode-1) time with full MDE criteria, and time to the first onset of state of full remission that lasted at least two consecutive months-2) time to full remission (Melartin et al, 2004).…”

Section: Follow-up Procedures 441 Outcome Measures and Life-chart Mementioning

confidence: 99%

See 2 more Smart Citations

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

Sokero¹,

Melartin²,

Rytsälä³

et al. 2003

J. Clin. Psychiatry

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300

220

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An Effectiveness Trial of Group Cognitive Behavioral Therapy for Patients With Persistent Depressive Symptoms in Substance Abuse Treatment

Watkins¹,

Hunter²,

Hepner³

et al. 2011

Arch Gen Psychiatry

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Context Although depression frequently co-occurs with substance abuse, few individuals entering substance abuse treatment have access to effective depression treatment. Objective The Building Recovery by Improving Goals, Habits and Thoughts (BRIGHT) study is a community-based effectiveness trial that compared residential substance abuse treatment to residential treatment plus group cognitive behavioral therapy (CBT) for depression delivered by substance abuse treatment counselors. The authors hypothesized that intervention clients would have improved depression and substance use outcomes as compared to clients receiving usual care. Design A nonrandomized controlled trial using a quasi-experimental intent-to-treat design in which four sites were assigned to alternate between the intervention and usual care conditions every four months over a two-and-a-half-year period. Setting Four treatment programs in Los Angeles County Participants 1,262 clients were screened for persistent depressive symptoms (Beck Depression Inventory-II (BDI-II) >17). 299 clients were assigned to receive either usual care (N=159) or usual care plus the intervention (N=140). Follow-up rates at three and six months after the baseline interview were 88.1% and 86.2% for usual care and 85.7% and 85.0% for the intervention group. Intervention Sixteen two-hour group sessions of CBT for depression Main Outcome Measures Change in depression symptoms, mental health functioning, and days of alcohol and substance use. Results BRIGHT clients reported significantly fewer depressive symptoms (p<0.001 at three and six months) and had improved mental health functioning (p<0.001 at three-months and p<0.01 at six months). At six months, BRIGHT clients reported fewer drinking days (p<0.05) and fewer days of problem substance use (p<0.05) on days available. Conclusions Providing group CBT for depression to clients with persistent depressive symptoms receiving residential substance abuse treatment is associated with improved depression and substance use outcomes. These results provide support for a new model of integrated care.

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Severity and Comorbidity Predict Episode Duration and Recurrence of DSM-IV Major Depressive Disorder

Cited by 142 publications

References 0 publications

Is it valid to measure suicidal ideation by depression rating scales?

Is it valid to measure suicidal ideation by depression rating scales?

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

An Effectiveness Trial of Group Cognitive Behavioral Therapy for Patients With Persistent Depressive Symptoms in Substance Abuse Treatment

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