Recovery From Major Depression: A 10-Year Prospective Follow-up Across Multiple Episodes
Abstract
BACKGROUND: Major depressive disorder is often marked by repeated episodes of depression. We describe recovery from major depression across multiple mood episodes in patients with unipolar major depression at intake and examine the association of sociodemographic and clinical variables with duration of illness. METHODS: A cohort of 258 subjects treated for unipolar major depressive disorder was followed up prospectively for 10 years as part of the Collaborative Depression Study, a multicenter naturalistic study of the mood disorders. Diagnoses were made according to the Research Diagnostic Criteria, and the course of illness was assessed with the Longitudinal Interval Follow-up Evaluation. Survival analyses were used to calculate the duration of illness for the first 5 recurrent mood episodes after recovery from the index episode. RESULTS: Diagnosis remained unipolar major depressive disorder for 235 subjects (91%). The median duration of illness was 22 weeks for the first recurrent mood episode, 20 weeks for the second, 21 weeks for the third, and 19 weeks for the fourth and fifth recurrent mood episodes; the 95% confidence intervals were highly consistent. From one episode to the next, the proportion of subjects who recovered by any one time point was similar. For subjects with 2 or more recoveries, the consistency of duration of illness from one recovery to the next was low to moderate. None of the sociodemographic or clinical variables consistently predicted duration of illness. CONCLUSION: In this sample of patients treated at tertiary care centers for major depressive disorder, the duration of recurrent mood episodes was relatively uniform and averaged approximately 20 weeks.
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The symptomatic outcome of BPD is better than that of other major mental illnesses like major depression or bipolar I disorder.
“Given these findings pertaining to symptomatic outcome, it seems fair to suggest that borderline personality disorder has a better symptomatic outcome than other major mental illnesses with which it is frequently compared, such as major depression (20,21) or bipolar I disorder (22,23).”
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- Authors
- Solomon, D. A.
- Affiliations
- Brown University (US)
- Corresponding author
- Solomon, David A.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1997-11-01
- Volume
- 54
- Issue
- 11
- Pages
- 1001
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2040925948
- Cited by
- 199
- References
- 22
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 8 · 2017: 3 · 2016: 12 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 6
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH025478)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- major depressive disorder, recovery from depression, disease duration, clinical course, sociodemographic predictors, clinical predictors
- MeSH terms
- Adult, Combined Modality Therapy, Depressive Disorder, Female, Follow-Up Studies, Humans, Imipramine, Male, Prospective Studies, Psychiatric Status Rating Scales, Psychotherapy, Recurrence, Severity of Illness Index, Social Class, Survival Analysis, Marital Status
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