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Cited by 76Treatment of Major DepressionBipolar Disorder and TreatmentAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Is the type of remission after a major depressive episode an important risk factor to relapses in a 4-year follow up?

Pintor, Luis, Torres, Xavier, Navarro, Victor, Matrai, Silvia, Gastó, Cristobal·2004·Journal of Affective Disorders
DOI 10.1016/j.jad.2003.11.008
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Abstract

Background Rates of relapse and predictive relapse factors were studied over more than 4 years in a sample of Spanish outpatients with DSM-III-R criteria for unipolar major depressive episode.Methods A final sample of 139 outpatient was followed monthly in a naturalistic study. The Structured Clinical Interview for DSM-III-R was used. Phases of evolution were recorded using the Hamilton Depression Rating Scale, applying the Frank criteria. Survival analysis, Kaplan-Meier product limit and proportional hazards models were used.Results A higher rate of relapses was observed in the partial remission group (91.4%) compared to the complete remission one (51.3%). The four factors with predictive relapse value were: "partial remission versus complete remission", "the intensity of clinical symptoms", "the age" and "the number of previous depressive episodes". The existence of partial remission was the most powerful predictive factor.Limitations The decreasing sample size during the follow-up and the difficulty in warranting the treatment compliance.Conclusions At medium term, relapse rates for a major depressive episode are high. Partial remission after a depressive episode seems to be an important predictive factor for relapses in a 4-year follow-up.Clinical relevance Not reaching complete remission is a strong risk factor for relapses in a 4-year follow up study.

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Crossref · 10.1016/j.jad.2003.11.008

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  • Remission as defined by Frank et al. (HAMD-17 ≤7) is associated with a better prognosis than not achieving this level of remission.

    “Some studies also showed that remission as defined by Frank et al. (1991), HAMD-17 ⩽7, is associated with a better prognosis than not achieving this level of remission (Paykel et al. 1995; Pintor et al. 2004).”

    From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Pintor et al. 2004

  • Some studies show that the currently often-used threshold (HAMD-17 ≤7; Frank et al. 1991) also differentiates prognosis.

    “Indeed, some studies show that the currently often-used threshold (HAMD-17 ⩽7; Frank et al. 1991) also differentiates in this regard (Paykel et al. 1995; Pintor et al. 2004).”

    From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Pintor et al. 2004

  • Residual depression symptoms in the non-depressed range strongly predict time to relapse/recurrence, including over long-term follow-up.

    “based on previous studies which show that residual symptoms in the non-depressed range are a strong predictor of time to relapse/recurrence, even over long-term follow-ups (Ali et al. 2017; Judd et al. 1997; Pintor et al. 2004).”

    From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Pintor et al. 2004

  • Clinical variables such as number of previous episodes, severity of last episode, and family history of MDD are strong predictors of recurrence.

    “However, clinical variables such as number of previous episodes [7, 11, 19–22], severity of last episode [21, 22] and family history of MDD [21– 23] were strong predictors of recurrence.”

    From Predictors of recurrence of major depressive disorder (2020) · cites this paper as [22]

  • A more severe first MDE has consistently been shown to be related to recurrence.

    “However, population and clinical studies that have been conducted used different classification systems for severity of first MDE which involved the duration of the first major depressive episode and number of symptoms present, but a more severe first MDE has consistently been shown to be related to recurrence [22].”

    From Predictors of recurrence of major depressive disorder (2020) · cites this paper as [22]

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Authors
Pintor, L., Torres, X., Navarro, V., Matrai, S., & Gastó, C.
Affiliations
Hospital Clínic de Barcelona (ES)
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2004-10
Volume
82
Issue
2
Pages
291-296
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2003.11.008
OpenAlex
W2054247262
Cited by
76
References
29
Citations by year
2026: 1 · 2023: 2 · 2022: 5 · 2020: 1 · 2019: 6 · 2018: 6 · 2017: 7 · 2016: 3 · 2015: 1 · 2014: 5 · 2013: 6 · 2012: 5
FWCI
1.47
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive episode, relapse, remission, partial remission, complete remission, relapse risk factors, major depressive disorder, outpatient depression, long-term follow-up, symptom intensity, age
MeSH terms
Adult, Aged, Antidepressive Agents, Major Depressive Disorder, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Male, Middle Aged, Personality Inventory, Prospective Studies, Recurrence, Risk Factors, Spain, Survival Analysis, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders

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