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Cited by 228Treatment of Major DepressionBipolar Disorder and TreatmentMental Health Treatment and Access

Pattern of recurrence of illness after recovery from an episode of major depression: a prospective study

Mario Maj, Franco Veltro, Raffaele Pirozzi, LOBRACE S., Lorenza Magliano·1992·American Journal of Psychiatry
DOI 10.1176/ajp.149.6.795
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Abstract

OBJECTIVE: This study assessed prospectively the pattern of recurrence of illness after recovery from an episode of major depression. METHOD: Seventy-two patients who had recovered from an episode of primary, nonbipolar, nonpsychotic major depression were evaluated bimonthly with the Comprehensive Psychopathological Rating Scale for a period ranging from 20 to 108 months (median = 66 months). New ("prospective") episodes were ascertained with a structured diagnostic interview. The probabilities of remaining well after the index episode and after the first prospective episode were assessed by the life-table method. The severity and duration of prospective episodes and the index episode were compared by linear regression analysis. RESULTS: The probability of remaining well after recovery from the index episode was 76% at 6 months, 63% at 1 year, and 25% at 5 years. The risk of recurrence was lower among patients receiving prophylactic treatment with antidepressants and/or lithium and among those with histories of fewer than three previous episodes. The probability of remaining well was significantly lower 2 years after the first prospective episode than 2 years after the index episode. A pattern of increasing severity from the index episode to the first, second, and third prospective episodes was observed and was not affected by treatment. CONCLUSIONS: Major depression has a high rate of recurrence, even when bipolar and psychotic cases are excluded. The highest rate is observed during the first months after recovery from an episode. Prophylactic drug treatment reduces the risk of recurrence but apparently does not affect the trend toward increasing severity of subsequent episodes.

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Crossref · 10.1176/ajp.149.6.795

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  • Other studies do not find such a sudden drop, instead suggesting that the diminishing hazard of return of symptoms is a gradual process rather than a discrete one.

    “Other studies do not find such a sudden drop at all, instead suggesting that the diminishing hazard of return of symptoms is a gradual process rather than a discrete one”

    From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Maj et al. 1992

  • 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 [20]

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Authors
Maj, M., Veltro, F., Pirozzi, R., S., L., & Magliano, L.
Affiliations
University of Naples Federico II (IT)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1992-06-01
Volume
149
Issue
6
Pages
795-800
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.149.6.795
OpenAlex
W54798487
Cited by
228
References
17
Citations by year
2025: 1 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 7 · 2013: 3 · 2012: 10
FWCI
5.22
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
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, recurrence, relapse after remission, antidepressant prophylaxis, lithium prophylaxis, episode severity, episode duration, remission, life table analysis
MeSH terms
Adult, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Recurrence, Risk Factors, Severity of Illness Index

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