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Cited by 489Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Natural History of Diagnostic Interview Schedule/ DSM-IV Major Depression: The Baltimore Epidemiologic Catchment Area Follow-up

Eaton, William W.·1997·Archives of General Psychiatry
DOI 10.1001/archpsyc.1997.01830230023003
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Abstract

BACKGROUND: Natural history can be characterized by incidence, recurrence, and duration of episodes. Research on the incidence of major depression is rare; studies of recurrence and duration are limited to clinical samples. METHODS: The Baltimore, Md, site of the Epidemiologic Catchment Area Program followed up its 1981 baseline cohort of 3481 respondents with an additional assessment in 1993 to 1996. Interviews were obtained from 1920 respondents (73% of the survivors). The Diagnostic Interview Schedule and the same survey procedures as in 1981 were used, augmented with a Life Chart Interview for dating the onset and duration of syndromes. RESULTS: There were 71 new cases of Diagnostic interview Schedule/DSM-IV major depression and 23,698 person-years of exposure, generating an estimated incidence of 3.0 per 1000 per year. Incidence peaked while subjects were in their 30s, with a smaller peak when they were in their 50s. Prodromal symptoms often occurred many years before the full criteria for diagnosis were met. Women were at higher risk for becoming new cases but had neither higher risk for recurrence nor longer episodes than men. Episodes of depression lasted for 12 weeks. The duration of an episode, and time to an episode-free year, was longer in the first episode than in recurrent episodes. CONCLUSIONS: The incidence estimated in this study is consistent with that found in the few other similar studies performed. The bimodality of onset suggests the value of further exploring the heterogeneity of depression via its natural history. Reported differences in prevalence between men and women seem to be due to differences in incidence, not chronicity.

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  • Results of studies on sociodemographic factors (age, gender, socioeconomic status, marital status) as risk factors for recurrence have been inconsistent.

    “Many studies showed that sociodemographic factors such as younger age, women, and those who have never been married were at higher risk of recurrence [7, 11–15]; however, results of other studies on these risk factors have been inconsistent.”

    From Predictors of recurrence of major depressive disorder (2020) · cites this paper as [13]

  • Some other studies found that age at onset and gender predict recurrence.

    “This is contrary to what some other studies have found [7, 11–15].”

    From Predictors of recurrence of major depressive disorder (2020) · cites this paper as [13]

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Authors
Eaton, W. W.
Affiliations
Johns Hopkins University (US)
Corresponding author
Eaton, William W.
ORCID
Eaton, William W.
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
1997-11-01
Volume
54
Issue
11
Pages
993
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.1997.01830230023003
OpenAlex
W2026384865
Semantic Scholar
0bf9197f675aff2aef88a6252cab9f7f4a8b7610
Cited by
489
References
45
Citations by year
2026: 3 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 13 · 2020: 11 · 2019: 10 · 2018: 12 · 2017: 46 · 2016: 21 · 2015: 15 · 2014: 15 · 2013: 16 · 2012: 28
FWCI
29.83
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH047447, MH 47447)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, incidence, recurrence, episode duration, prodromal symptoms, sex differences, depression onset
MeSH terms
Adolescent, Adult, Aged, Catchment Area, Health, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Recurrence, Sex Factors, Baltimore, Incidence, Prevalence, Proportional Hazards Models, Survival Analysis, Age of Onset, Age Distribution

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