Relapse in Major Depressive Disorder: Analysis With the Life Table

Published on Aug 1, 1982in Archives of General Psychiatry
· DOI :10.1001/archpsyc.1982.04290080031005
Martin B. Keller113
Estimated H-index: 113
,
Robert W. Shapiro13
Estimated H-index: 13
+ 1 AuthorsNicola Wolfe2
Estimated H-index: 2
Abstract
• With the use of life tables to describe time while patients were well and subsequent rates of relapse for 75 patients after their recovery from an episode of major depressive disorder in a naturalistic study, a high risk of relapse was detected shortly after recovery. Twenty-four percent of patients relapsed within 12 weeks at risk, and 12% of patients relapsed within four weeks at risk. The presence of an underlying chronic depression and three or more previous affective episodes predicted a statistically significant increase in the rate of relapse. These data were used to develop an exponential model of relapse probability for a subgroup of the study population.
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  • Citations (209)
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References21
Published on Apr 1, 1982in American Journal of Psychiatry 13.40
Martin B. Keller113
Estimated H-index: 113
,
Robert W. Shapiro13
Estimated H-index: 13
Although ‘ ‘double depression ‘ ‘-major depressive disorder superimposed on an underlying chronic depression-is a f requent phenomenon, the concept has not been well formulated clinically and has rarely been described in the research literature. The authors found that 1) 26% of 101 patients who met the criteria for major depressive disorder had an underlying chronic depressive disorder of at least 2 years’ duration, 2) “recovery” ratesfor patients with superimposed depression differed greatly de...
275 Citations Source Cite
Published on Sep 1, 1981in Journal of Affective Disorders 3.79
Robert W. Shapiro13
Estimated H-index: 13
(Massachusetts Mental Health Center),
Martin B. Keller113
Estimated H-index: 113
(Harvard University)
Abstract Results from 121 patients with major depressive disorder followed-up at 6 months with a new comprehensive follow-up schedule, the Longitudinal Interval Follow-Up Evaluation (LIFE) indicate that: 1. (1) Forty percent of patients had not recovered from the index episode 6 months after inclusion; 2. (2) Of those patients who recovered, 19% relapsed into another RDC affective episode by the time of the 6-months follow-up, and an additional 24% developed some subsequent affective symptoms by...
50 Citations Source Cite
Published on Dec 1, 1981in Journal of Nervous and Mental Disease 1.94
Martin B. Keller113
Estimated H-index: 113
,
Robert W. Shapiro13
Estimated H-index: 13
The authors present a 1-year prospective, naturalistic, longitudinal follow-up of 101 patients with the Research Diagnostic Criteria diagnosis of definite major depressive disorder. Seventy-four per cent of patients recover by 1 year. Of those who do recover, 36. per cent have subsequent Research Diagnostic Criteria affective episodes within the year. Episodes are of long duration for both the recovered and nonrecovered patients, being 30 weeks and at least 99 weeks, respectively. Certain common...
97 Citations Source Cite
Published on Jan 1, 1981in Archives of General Psychiatry
Jean Endicott94
Estimated H-index: 94
,
Jacob Cohen58
Estimated H-index: 58
+ 2 AuthorsStavros Sarantakos5
Estimated H-index: 5
• Investigators who wish to use new procedures usually wish to relate their results to those already in the literature. This often results in the use of both old and new measures. The Schedule for Affective Disorders and Schizophrenia Regular and Change Versions (SADS and SADS-C) have advantages over the widely used Hamilton Depression Rating Scale (HDRS). A procedure was developed to extract the HDRS score from the SADS and SADS-C. The comparative reliability and the validity of the extracted H...
335 Citations Source Cite
Published on Jul 1, 1979in Archives of General Psychiatry
Martin M. Katz18
Estimated H-index: 18
(National Institutes of Health),
Steven Secunda5
Estimated H-index: 5
(National Institutes of Health)
+ 1 AuthorsStephen H. Koslow33
Estimated H-index: 33
(National Institutes of Health)
• This is a report on the history and implications of the collaborative effort that evolved from the 1969 National Institute of Mental Health conference on the psychobiology of depression. The major issues identified at that time were the need to (1) assess relative validities of current systems of nosology and (2) retest critical biological hypotheses concerning the etiology and nature of the depressive disorders. Research was required that would be multidisciplinary and involve clinical settin...
191 Citations Source Cite
Published on Jun 1, 1958in Journal of the American Statistical Association 2.30
E. L. Kaplan1
Estimated H-index: 1
(University of California, Berkeley),
Paul Meier37
Estimated H-index: 37
(University of Chicago)
Abstract In lifetesting, medical follow-up, and other fields the observation of the time of occurrence of the event of interest (called a death) may be prevented for some of the items of the sample by the previous occurrence of some other event (called a loss). Losses may be either accidental or controlled, the latter resulting from a decision to terminate certain observations. In either case it is usually assumed in this paper that the lifetime (age at death) is independent of the potential los...
40.9k Citations Source Cite
Published on Jul 1, 1976in British Journal of Psychiatry 5.87
David L. Dunner57
Estimated H-index: 57
,
Joseph L. Fleiss64
Estimated H-index: 64
,
Ronald R. Fieve41
Estimated H-index: 41
Data from non-rapid-cycling bipolar (manic-depressive) patients who were receiving long-term treatment with lithium carbonate were analysed by the life table method to determine when lithium carbonate prophylaxis failures occurred. Forty-four of 96 patients failed to keep well in spite of maintenance lithium therapy. The analysis revealed an early, rapid failure rate during the first six months of treatment, which was followed by a slower rate of failure. Several clinical factors were assessed t...
64 Citations Source Cite
Published on Jan 1, 1978in Comprehensive Psychiatry 2.13
Myrna M. Weissman3
Estimated H-index: 3
(Yale University),
Brigitte A. Prusoff1
Estimated H-index: 1
(Yale University),
Gerald L. Klerman73
Estimated H-index: 73
(Yale University)
Abstract Anyclinician who follows patients under naturalistic clinic conditions accumulates a wealth of observations about their responses to various treatments. Without random assignment to treatment or other features of the controlled experimental design, information on treatment efficacy obtained from these naturally occurring situations is limited. However, through the use of appropriate statistical techniques such as life table method, considerably more information may be extracted. Althoug...
6 Citations Source Cite
Published on Jul 20, 1979in Archives of General Psychiatry
Athanasios P. Zis36
Estimated H-index: 36
,
Frederick K. Goodwin86
Estimated H-index: 86
The systematic study of the natural course of affective disorders originated with the pioneer work of Kraepelin 1 and has continued until recently. However, with the advent of lithium and its widespread use in the prophylaxis of affective disorders, naturalistic data on the course of the illness has become increasingly unavailable. While reviewing the literature on the subject, one is struck by the discrepancies in the reported results and particularly the disparities concerning the proportion o...
155 Citations Source Cite
Published on Jul 1, 1978in Comprehensive Psychiatry 2.13
Joseph L. Fleiss64
Estimated H-index: 64
,
Robert F. Prien5
Estimated H-index: 5
+ 1 AuthorsRonald R. Fieve41
Estimated H-index: 41
Abstract The existence of two large-scale comparative longitudinal studies of lithium prophylaxis 1,2 provides a rare opportunity for comparing and combining information on the course of manic-depressive illness and how the course is modified when patients are maintained on lithium carbonate. This report describes our success in constructing relatively simple mathematic models for the rates of relapse in manic-depressive illness under both lithium carbonate and control treatment using data from ...
15 Citations Source Cite
Cited By209
Published on Jul 1, 1986in American Journal of Psychiatry 13.40
Carlo Faravelli40
Estimated H-index: 40
,
Alessandra Ambonetti6
Estimated H-index: 6
+ 1 AuthorsAdolfo Pazzagli10
Estimated H-index: 10
METHOD Of 1 01 patients suffering from primary unipolar depression who were followed up for at least 1 year after recovery from the index episode, 51 relapsed into a new depressive episode within the year of recovery. Only those variables related to the period immediately after discharge distinguished nonrelapsers from relapsers; relapsers showed higher levels of residual symptoms, inferior social adaptation, a more pathological mean personality profile, and lower tricyclic plasma levels, despit...
126 Citations Source Cite
Published on Sep 1, 2005in Dialogues in clinical neuroscience 3.67
David J. Kupfer125
Estimated H-index: 125
Depressive disorders are common, recurrent, and chronic, and require treatment A review of the symptom picture and current drug targets demonstrates the need for accument of depression severity, including suicidaliltial focus of treatment is rapid resolution of: during an acute phase, followed by continuation. Maintenance treatment is indicated if the risk of recurrence is high. The range of available medications is considerable and the benefit/risk ratio is acceptable. Depression is diagnosable...
26 Citations
Published on May 1, 1994in Psychosomatics 2.53
Kenneth B. Wells83
Estimated H-index: 83
(Semel Institute for Neuroscience and Human Behavior)
Prepaid or prospective reimbursement has implications for the the consultation-liaison (C-L) psychiatrist. The author reviews results from three health policy studies that indicated 1) degree of reliance on general medical providers for mental health care is not affected by generosity of fee-for-service (FFS) coverage, but is greater in some prepaid health care systems; 2) psychological sickness of depressed outpatients visiting general medical providers is similar across prepaid and FFS svstemn...
31 Citations Source Cite
Published on Sep 1, 1984in International Journal of Mental Health
Peter M. Lewinsohn94
Estimated H-index: 94
(University of Oregon),
Julia L. Steinmetz4
Estimated H-index: 4
(University of Oregon)
+ 1 AuthorsLinda Teri7
Estimated H-index: 7
(University of Oregon)
In this paper we describe the Coping with Depression course as it has been offered at the University of Oregon Depression Research Unit since 1979. The Coping with Depression course is a multimodal, psychoeducational group treatment for unipolar depression. The major vehicle for treatment is a course, i.e., an explicit educational experience; it is called a course because it teaches people techniques and strategies for coping with the problems that are assumed to be related to their depression. ...
32 Citations Source Cite
Published on Sep 1, 1995in The Canadian Journal of Psychiatry
Yvon Lapierre2
Estimated H-index: 2
,
Judith D. Bentkover15
Estimated H-index: 15
+ 1 AuthorsSteven Manners1
Estimated H-index: 1
Objectif : Evaluer, grâce a une analyse cout/efficacite, les repercussions economiques possibles de l'introduction de nouveaux antidepresseurs plus dispendieux sur le cout global du traitement. Methode : Dans le cadre de cette analyse, on a elabore un arbre de decision informatise pour la medecine clinique afin de modeliser le traitement de la depression moderee a grave au Canada, sur une duree de douze mois. Le modele a ete complete grâce aux donnees obtenues de panels de medecins, du ministere...
32 Citations Source Cite
Published on Jan 1, 2000in Biological Psychiatry 11.98
A. J. Rush108
Estimated H-index: 108
(University of Texas Southwestern Medical Center),
Mark S. George86
Estimated H-index: 86
(Medical University of South Carolina)
+ 7 AuthorsRobert R. Goodman39
Estimated H-index: 39
(Columbia University)
Published on Jul 1, 2002in Clinical Psychology Review 9.58
Kate E. Hamilton2
Estimated H-index: 2
(University of Calgary),
Keith S. Dobson41
Estimated H-index: 41
(University of Calgary)
Abstract This review examines the role of patient predictors of outcome in cognitive therapy of depression. Studies that meet eligibility criteria are reviewed for demonstrated linkage between various predictors (i.e., pretreatment severity, historical features, demographic predictors, dysfunctional attitudes and other cognitive features, and treatment acceptability) and outcome, and several effects are found. Notably, high pretreatment severity scores are associated with poorer response to cogn...
6,175 Citations Source Cite
Published on Sep 1, 1988in Medical Clinics of North America 2.58
Susan J. Blumenthal1
Estimated H-index: 1
This article summarizes what is known about risk factors for suicide in both adolescent and adult populations. It also translates this knowledge base into practical considerations for the physician on the assessment and treatment of suicidal patients. Since most patients who commit suicide have seen a physician in the weeks to month prior to their deaths, and many kill themselves with medications prescribed by their doctors, the physician's early detection and treatment of suicidal behaviors and...
101 Citations Source Cite
Published on Jan 1, 1998in Journal of Affective Disorders 3.79
Lars Vedel Kessing50
Estimated H-index: 50
(University of Copenhagen),
Peter Mortensen92
Estimated H-index: 92
,
Tom G. Bolwig40
Estimated H-index: 40
(University of Copenhagen)
The observation of a progressive recurrence in affective disorder has been interpreted as a process of sensitisation. The clinical applicability of such a theoretical model was investigated using the Danish case register, which includes all hospital admissions with primary affective disorder in Denmark from 1971 to 1993. A total of 8,737 patients admitted to a psychiatric hospital at least twice constituted the study sample. Information on treatment intervention was not available. Measures descr...
33 Citations Source Cite
Published on Jun 1, 1989in American Journal of Psychiatry 13.40
Giles De1
Estimated H-index: 1
(University of Texas Southwestern Medical Center),
Robin B. Jarrett32
Estimated H-index: 32
+ 2 AuthorsRush Aj7
Estimated H-index: 7
(University of Texas Southwestern Medical Center)
In a longitudinal study of 30 successfully treated unipolar depressed patients, the authors evaluated number of depressive episodes, early onset of depression, and lifetime prevalence of affective disorders other than major depression as risk factors for recurrence. Early onset of depression (before age 20) and a history of affective disorders other than major depression were each significantly associated with recurrence. Number of episodes was not as powerful in predicting recurrence as either ...
55 Citations Source Cite