Please use this identifier to cite or link to this item: https://doi.org/10.1017/S0033291711002170
Title: Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report
Authors: Rush, A.J. 
Wisniewski, S.R.
Zisook, S.
Fava, M.
Sung, S.C.
Haley, C.L.
Chan, H.N.
Gilmer, W.S.
Warden, D.
Nierenberg, A.A.
Balasubramani, G.K.
Gaynes, B.N.
Trivedi, M.H.
Hollon, S.D.
Keywords: Chronic
Course of illness
Depression
Outcomes
Recurrent
Issue Date: Jun-2012
Citation: Rush, A.J., Wisniewski, S.R., Zisook, S., Fava, M., Sung, S.C., Haley, C.L., Chan, H.N., Gilmer, W.S., Warden, D., Nierenberg, A.A., Balasubramani, G.K., Gaynes, B.N., Trivedi, M.H., Hollon, S.D. (2012-06). Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report. Psychological Medicine 42 (6) : 1131-1149. ScholarBank@NUS Repository. https://doi.org/10.1017/S0033291711002170
Abstract: Background Major depressive disorder (MDD) is commonly chronic and/or recurrent. We aimed to determine whether a chronic and/or recurrent course of MDD is associated with acute and longer-term MDD treatment outcomes.Method This cohort study recruited out-patients aged 18-75 years with non-psychotic MDD from 18 primary and 23 psychiatric care clinics across the USA. Participants were grouped as: chronic (index episode >2 years) and recurrent (n=398); chronic non-recurrent (n=257); non-chronic recurrent (n=1614); and non-chronic non-recurrent (n=387). Acute treatment was up to 14 weeks of citalopram (≤60 mg/day) with up to 12 months of follow-up treatment. The primary outcomes for this report were remission [16-item Quick Inventory of Depressive Symptomatology-Self-Rated (QIDS-SR16) ≤5] or response (≥50% reduction from baseline in QIDS-SR16) and time to first relapse [first QIDS-SR16 by Interactive Voice Response (IVR) ≥11].Results Most participants (85%) had a chronic and/or recurrent course; 15% had both. Chronic index episode was associated with greater sociodemographic disadvantage. Recurrent course was associated with earlier age of onset and greater family histories of depression and substance abuse. Remission rates were lowest and slowest for those with chronic index episodes. For participants in remission entering follow-up, relapse was most likely for the chronic and recurrent group, and least likely for the non-chronic, non-recurrent group. For participants not in remission when entering follow-up, prior course was unrelated to relapse.Conclusions Recurrent MDD is the norm for out-patients, of whom 15% also have a chronic index episode. Chronic and recurrent course of MDD may be useful in predicting acute and long-term MDD treatment outcomes. © 2012 Cambridge University Press.
Source Title: Psychological Medicine
URI: http://scholarbank.nus.edu.sg/handle/10635/110571
ISSN: 00332917
DOI: 10.1017/S0033291711002170
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

31
checked on Oct 22, 2018

WEB OF SCIENCETM
Citations

28
checked on Oct 22, 2018

Page view(s)

41
checked on Oct 19, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.