Long term outcome of primary care depression
Open accessAbstract
We conducted a follow up over 23 years of depressed patients originally presenting to general practice in 1981 and studied in detail at that time. Aims were to assess the long term course and outcome of depression in primary care. Patterns of recovery and recurrence of major depressive episodes, together with other aspects of course, treatment and current state, were assessed at interview. 78% (129) of the original sample were traced to current general practice and outcome data obtained on 54. One third had a prior history of depression. Interview data were obtained on 37 patients. Time to recovery from baseline averaged 10.3 months. The recurrence rate was 64% (23). Most participants suffered at least 2 further episodes that were frequently chronic lasting 2 years on average. Time before first recurrence appeared considerably longer than in comparable psychiatric inpatient samples. No participants were continuously ill. Although loss to follow up limits our conclusions, the course of primary care depression appears worse than suggested by previous, shorter follow ups. Our data suggest that long term risk of a recurrence may be high, but with recurrence delayed.
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A third group of studies shows atypical survival curves where the time-specific risk of return of symptoms even increases over time during certain time intervals.
“A third group of studies shows atypical survival curves where the time-specific risk of return of symptoms even increases over time during certain time intervals”
From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Yiend et al. 2009
In major depressive disorder, 18-77% of patients experienced a relapse.
“Likewise, with regard to major depressive disorder (MDD), 18–77% of patients experienced a relapse [22–28].”
From Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as [25]
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- Authors
- Yiend, J., Paykel, E., Merritt, R., Lester, K., Doll, H., & Burns, T.
- Affiliations
- University of Oxford (GB)
- University of Cambridge (GB)
- Corresponding author
- Yiend, Jenny
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 118
- Issue
- 1-3
- Pages
- 79-86
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2039788339
- Cited by
- 67
- References
- 8
- Citations by year
- 2023: 2 · 2022: 5 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 7 · 2016: 4 · 2015: 3 · 2014: 7 · 2013: 4 · 2012: 5
- FWCI
- 9.97
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Kent Academic Repository (University of Kent) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Medical Research Council
- 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
- depression, long-term outcomes, primary care, general practice, recurrence, chronic depression, recovery time, major depressive episode, follow-up
- MeSH terms
- Adult, Aged, Antidepressive Agents, Chronic Disease, Combined Modality Therapy, Counseling, Major Depressive Disorder, Female, Humans, London, Long-Term Care, Longitudinal Studies, Male, Middle Aged, Outcome and Process Assessment, Health Care, Primary Health Care, Recurrence, Referral and Consultation, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
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