American Journal of Psychiatry · 2000 · 836 citations · 19 references
MedicinePsychiatryAdult PsychiatryClinical PsychologySurvival AnalysisDepressionDepressive DisordersPsychiatric EpidemiologyRelapse PreventionDepression PrognosisMajor DepressionRecurrence In DepressionRelapse In Depression
The study examined multiple recurrences of unipolar major depressive disorder. A prospective 10‑year multicenter naturalistic study of 318 patients used survival analysis to assess recurrence risk after recovery. During the 10‑year follow‑up, 0.21 episodes per patient‑year were recorded, nearly two‑thirds of patients recurred, each additional episode increased recurrence risk by 16%, longer recovery periods lowered risk, and recurrence timing varied, underscoring the highly recurrent nature of major depression.
OBJECTIVE: The authors of this study examined multiple recurrences of unipolar major depressive disorder. METHOD: A total of 318 subjects with unipolar major depressive disorder were prospectively followed for 10 years within a multicenter naturalistic study. Survival analytic techniques were used to examine the probability of recurrence after recovery from the index episode. RESULTS: The mean number of episodes of major depression per year of follow-up was 0.21, and nearly two-thirds of the subjects suffered at least one recurrence. The number of lifetime episodes of major depression was significantly associated with the probability of recurrence, such that the risk of recurrence increased by 16% with each successive recurrence. The risk of recurrence progressively decreased as the duration of recovery increased. Within subjects, there was very little consistency in the time to recurrence. CONCLUSIONS: Major depressive disorder is a highly recurrent illness. The risk of the recurrence of major depressive disorder progressively increases with each successive episode and decreases as the duration of recovery increases.
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The Statistical Analysis of Failure Time Data.
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