Abstract
This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i) single or few episodes followed by long-lasting remission; ii) single or few episodes followed by long-lasting remission, although shorter; iii) single or few episodes followed by late recurrence; iv) single or few episodes, but more frequently ill, followed by late recurrence; v) several episodes followed by lasting remission; vi) chronic course of episodes. Remission or recurrence could therefore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission.
Highlights
Background factorsHeredity shows an odds ratio of 5.09, P=0.002 for chronicThere were similar rates in adequate treatment at index admission between short-term and chronic course, 47/51 (92%), versus 21/24 (88%)
A review article of followwas significantly related to a chronic course are the best predictors of the course in early up studies of depressed patients concludes with or without late remission
All probands e had given their written informed consent to s participate in the study. ial u Results rc Self-reported course of depression e When all ill episodes, including all true m episodes, were separated from well episodes, a cluster analysis using the variables m described above gave six different groups o describing six different long-term courses of c severe depression. - The clusters are described in Table 2 and n were as follows: i) cluster A single or few episodes followed by long-lasting remission: o this cluster contained 15 persons, 6 men and 9 N women; ii) cluster B single or few episodes fol
Summary
Plete, information about 33 persons apart from *Such as artrosis or cardiac failure; **such as appendicitis or tbc; ***such as rheumatoid arthritis or diabetes. - Number of well episodes and number of ill seen very late in the course. - Length of the longest period of wellness and are presented in the form of life-charts in than negative experiences of childhood was length of the total time of illness; Figure 1. - Length of the latest well episode and length The rates of different course for participants Socio-demographic factors, such as marital of the latest ill episode. Those who declined but gave some infor- status and socioeconomic class did not differ-. Cluster analyses were performed with both reported long-term wellness
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