Cited by 236Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Remission and relapse in major depression: a two-year prospective follow-up study

Ramana, R., Paykel, E. S., Cooper, Z., Hayhurst, H., Saxty, M., Surtees, P. G.·1995·Psychological Medicine

DOI 10.1017/s0033291700033134

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Abstract

Synopsis: This paper reports the course with respect to remission and relapse of a cohort of predominantly in-patient RDC major depressive subjects, who were followed at 3-monthly intervals to remission and for up to 15 months thereafter. Remission was comparatively rapid with 70% of subjects remitting within 6 months. Only 6% failed to do so by 15 months. However, 40% relapsed over the subsequent 15 months, with all the relapses occurring in the first 10 months. Greater severity of the depression and longer duration of the illness predicted a longer time to remission. Greater initial severity of depression also predicted relapse. Subjects with a worse outcome had not received less adequate treatment than the remainder. Our results confirm the comparatively poor outcome subsequent to remission that has been reported in recent literature, in spite of the availability of modern methods of treatment. The clustering of relapses in the first 10 months gives some support to the distinction between relapse and later recurrence.

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Background
Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study
Harada, E., Satoi, Y., Kuga, A., Tokuoka, H., Kikuchi, T., Watanabe, K., Alev, L., & Mimura, M. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s134566 · Cited by 7
“Indeed, approximately one third of patients experience persistent residual symptoms and fail to reach remission.(3,4) A previous study reported that patients with MDD who had residual symptoms relapsed more than three times faster than those who did not have residual symptoms.”
Intermediate-term Outcome of Psychiatric Inpatients with Major Depression
Tseng, M. M., Cheng, I.-C., Lee, Y.-J., & Lee, M. (2006) · Journal of the Formosan Medical Association · doi:10.1016/s0929-6646(09)60163-7 · Cited by 7
Special Treatment Issues: Maintaining and Discontinuing Psychotropic Medications
Suppes, T. M., Baldessarini, R. J., Motohashi, N., Tondo, L., & Viguera, A. C. (1997) · KARGER eBooks · doi:10.1159/000061671 · Cited by 7
The Long-Term Management of Major Depressive Disorders
Shelton, R. C., & Hollon, S. D. (2012) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.10.4.434 · Cited by 7
Well-being Therapy in Depressive Disorders
Mansueto, G., & Cosci, F. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-981-33-6044-0_19 · Cited by 7
Predictive effects of previous episodes on the risk of recurrence in depressive and bipolar disorders
Kessing, L. V., & Andersen, P. K. (2005) · Current Psychosis & Therapeutics Reports · doi:10.1007/bf02629400 · Cited by 6
Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente
Peñaranda, A. P. B., Valencia, J. G., Guarín, M. R., Borrero, Á. E. A., Castro, S., Bradford, A. M. D. L. H., Riveros, P. M., Jaramillo, L. E., Brito, E., Acosta, C. A. P., et al. (2012) · Revista Colombiana de Psiquiatría · doi:10.1016/s0034-7450(14)60045-7 · Cited by 7
One-year course of the first vs. multiple episodes of depression—Polish naturalistic study
RYBAKOWSKI, J. K., Nawacka-Pawlaczyk, D., & Kiejna, A. (2004) · European Psychiatry · doi:10.1016/j.eurpsy.2004.06.004 · Cited by 6
“episode and heralds a chronic course of the illness [10,16,18].”
Background
Depression and partial remission after short-term treatment
Vuorenmaa, J., Nordling, E., Riihikangas, R., Hintikka, J. J., & Viinamäki, H. T. (1999) · Nordic Journal of Psychiatry · doi:10.1080/080394899426800 · Cited by 6
Chronic depression : Determinants and consequences of chronic major depression in the general population
Spijker, J. (2002) · Utrecht University Repository (Utrecht University) · Cited by 6
Observing the determinants of the psychotherapeutic process in depressive disorders. A clinical case study within a psychodynamic approach
Oasi, O. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00477 · Cited by 5
Mindful Yoga Versus Relaxation for Young Adults With Symptoms of Depression: A Randomized Controlled Comparison of Two Brief Laboratory-Based Interventions
Vollbehr, N. K., Hoenders, R. H. J., Bartels‐Velthuis, A. A., de Jong, P. J., & Ostafin, B. D. (2025) · Mindfulness · doi:10.1007/s12671-024-02502-7 · Cited by 6
“treatments have non-response rates of up to 50% (Preskorn, 2013; Schindler et al., 2013) and relapse rates may be as high as 50% within 2 years after treatment (Ramana et al., 1995; Vittengl et al., 2007).”
History of Single Episode and Recurrent Major Depressive Disorder Among Smokers in Cessation Treatment
Cohn, A. M., Strong, D. R., Abrantes, A. M., & Brown, R. A. (2010) · Addictive Disorders & Their Treatment · doi:10.1097/adt.0b013e3181b91c6b · Cited by 5
Paroxetine drops versus paroxetine tablets: evaluation of compliance in a six-month study
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Depressive Episode und rezidivierende depressive Störung
Laux, G. (2003) · Springer eBooks · doi:10.1007/3-540-27386-7_50 · Cited by 5
De (in)effectiviteit van psychofarmaca
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Mineral Intake and Depression: A Cross-Sectional Comparative Study Based on National Health and Nutrition Examination Surveys in Korea and the United States
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“Recent studies have found that a reluctance to seek professional help is associated with damaging interpersonal relationships and the stigmas of mental illness [6,7].”
Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression
Marca, R. L., Pallich, G., Holtforth, M. G., & Hochstrasser, B. (2022) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000299 · Cited by 5
Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente
Gómez–Restrepo, C., Peñaranda, A. P. B., Valencia, J. G., Guarín, M. R., Narváez, E. B., Jaramillo, L. E., Acosta, C. A. P., Pedraza, R. S., & Castro, S. (2012) · Revista Colombiana de Psiquiatría · doi:10.1016/s0034-7450(14)60044-5 · Cited by 4
Clinical Applications of Well‐Being Therapy
Ruini, C., & Fava, G. A. (2015) · doi:10.1002/9781118996874.ch28 · Cited by 4
Six Months of Treatment for Depression: Outcome and Predictors of the Course of Illness
Mulder, R., Joyce, P. R., FRAMPTON, C. M. A., Luty, S. E., & Sullivan, P. F. (2010) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.8.2.foc286 · Cited by 3
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Melartin, T. K. (2005) · STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) · Cited by 3
Pharmacological treatment of major depression
Vázquez, G. H. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-33580-8.00018-0 · Cited by 3
Augmenting neurocognitive remediation therapy to Preventive Cognitive Therapy for partially remitted depressed patients: protocol of a pragmatic multicentre randomised controlled trial
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Socioeconomic disadvantage affects course and recurrence of psychiatric disability
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Reducing barriers to help-seeking in ethnic minorities in the USA: a call for increased adoption of alternative mental health approaches
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Dépressions sévères : récurrence et chronicité
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Revisão das diretrizes da Associação Médica Brasileira para o tratamento da depressão (Versão integral) Revision of the guidelines of the Brazilian Medical Association for the treatment of depression (Complete version)
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Für jeden Patienten den optimalen Wirkstoff finden
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Patterns of persistence with pharmacological treatment among patients with current depressive episode and their impact on long-term outcome: a naturalistic study with 5-year follow-up
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“…the long-term pattern of persistence with pharmacological treatment among patients with MDE, recurrence or relapse rates of 40%–90% in 2–5 years among UD or BD patients reported from naturalistic prospective studies 19–21 imply a similar long-term pattern of medication persistence with this study.”
Risque de chronicisation
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Depressive Disorders in Primary Health Care
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BUILDING MENTAL HEALTH IN YOUNG AUSTRALIANS: A POSITIVE PSYCHOLOGICAL APPROACH
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Het beloop van depressie
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Depressive Störungen
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New Applications of Well-Being Therapy
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Authors: Ramana, R., Paykel, E. S., Cooper, Z., Hayhurst, H., Saxty, M., & Surtees, P. G.
Affiliations: University of Cambridge (GB)
Corresponding author: Ramana, R.
ORCID: Cooper, Z.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 1995-11
Volume: 25
Issue: 6
Pages: 1161-1170
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291700033134
OpenAlex: W2099075065
Cited by: 236
References: 53
Citations by year: 2025: 4 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 9 · 2016: 8 · 2015: 9 · 2014: 9 · 2013: 5 · 2012: 10
FWCI: 3.88
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified, 4999 d)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: major depressive disorder, remission, relapse, recurrence, inpatient depression, depression severity, disease duration, treatment outcomes, recurrence prediction
MeSH terms: Adolescent, Adult, Aged, Antidepressive Agents, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Recurrence, Remission, Spontaneous

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Remission and relapse in major depression: a two-year prospective follow-up study

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