Six Months of Treatment for Depression: Outcome and Predictors of the Course of Illness
Abstract
Objective The goals of this study were to determine the course of illness in a cohort of depressed patients undergoing treatment for 6 months and whether there are clinically useful predictors of their course of illness. Method A cohort of 175 depressed outpatients undergoing drug treatment were followed prospectively for 6 months. Patients were initially randomly assigned to fluoxetine or nortriptyline. Those who responded were encouraged to continue taking their drugs for the 6 months. Those who did not were switched to other drugs or drug combinations. Results Of the 175 patients, 101 (58%) had a good outcome (achieved recovery and remained well), 54 (31%) had a fluctuating outcome (achieved recovery or remission but suffered a relapse or recurrence), and 20 (11%) had a poor outcome (remained depressed for the 6 months). Factors predicting good outcome included early response and a low level of schizoid personality disorder symptoms, and variables predicting poor outcome included a high score for harm avoidance and the absence of an early response. Conclusions Depression is a recurring and chronic disorder. Personality factors such as a high harm avoidance score and schizoid traits were associated with a worse outcome, but demographic features, depression characteristics, depression subtypes, and comorbidity were not. Early response was strongly associated with the course of illness, but none of these features added significantly to the clinicians' ability to predict outco…
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Comorbid SAD in pharmacotherapy studies is associated with a poorer course of illness, treatment-resistant depression, and a greater number and earlier onset of depressive recurrences compared with patients without comorbid SAD.
“This comorbidity pattern may also affect treatment outcomes, with pharmacotherapy studies indicating that comorbid SAD is associated with a poorer course of illness (Mulder, Joyce, Frampton, Luty, & Sullivan, 2006), treatment-resistant depression (Souery et al., 2007), and a greater number and earlier onset of depressive recurrences compared with patients without comorbid SAD (Holma, Holma, Melart”
From An Integrated, Acceptance-Based Behavioral Approach for Depression With Social Anxiety: Preliminary Results (2014) · cites this paper as Mulder, Joyce, Frampton, Luty, & Sullivan, 2006
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- Authors
- Mulder, R. T., Joyce, P. R., Frampton, C. M. A., Luty, S. E., & Sullivan, P. F.
- Affiliations
- University of Otago (NZ)
- Venue
- American Journal of Psychiatry
- Published
- 2006-01-01
- Volume
- 163
- Issue
- 1
- Pages
- 95-100
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2126881608
- Cited by
- 127
- References
- 2
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 6 · 2021: 3 · 2020: 4 · 2019: 7 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 2 · 2014: 6 · 2013: 6 · 2012: 13
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- depression, clinical course, treatment outcome prediction, fluoxetine, nortriptyline, early treatment response, harm avoidance, relapse and recurrence, antidepressant treatment, outpatients
- MeSH terms
- Adult, Ambulatory Care, Antidepressive Agents, Antidepressive Agents, Tricyclic, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Personality Disorders, Personality Inventory, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Cohort Studies, Comorbidity, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Secondary Prevention
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