Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T17:29:14.041Z Has data issue: false hasContentIssue false

Recurrent Depression: Patient Characteristics, Clinical Course, and Current Recommendations for Management

Published online by Cambridge University Press:  07 November 2014

Abstract

A significant proportion of depressed patients will experience multiple episodes of depression throughout their lifetimes, and, in recent years, attention has been paid to the identification of risk factors associated with a recurrent course of major depression. Residual depressive symptoms following acute phase therapy appears to be the most important clinical risk factor leading to recurrence. However, advances in empirically-supported treatment algorithms and guidelines, and in pharmacotherapy and psychotherapy, provide physicians with the tools necessary to improve short- and long-term outcomes in the treatment of depression. Additionally, recent developments in genetic and psychological vulnerability research have sought to further improve outcomes by identifying markers in patients who may likely experience multiple depressive episodes.

Type
Supplement
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Simon, GE. Long-term prognosis of depression in primary care. Bull World Health Organ. 2000;78:439445.Google ScholarPubMed
2.World Health Organization. The World Health Report 2001: Mental Health: New Understanding, New Hope. Geneva, Switzerland: 2001.Google Scholar
3.Murray, CJ, Lopez, AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349:14981504.CrossRefGoogle ScholarPubMed
4.Kessler, RC, Berglund, P, Demler, O, Jin, R, Walters, EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593602.CrossRefGoogle ScholarPubMed
5.Judd, LL, Paulus, MJ, Schettler, PJ, et al.Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness? Am J Psychiatry. 2000;157:15011504.CrossRefGoogle Scholar
6.American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Second Edition. Arlington, VA: American Psychiatric Association: 2000.Google Scholar
7.American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002;159:150.Google Scholar
8.Ghaemi, SN, Hsu, DJ, Soldani, F, Goodwin, FK. Antidepressants in bipolar disorder: the case for caution. Bipolar Disord. 2003;5:421433.CrossRefGoogle ScholarPubMed
9.Post, RM, Leverich, GS, Nolen, WA, et al.A re-evaluation of the role of antidepressants in the treatment of bipolar depression: data from the Stanley Foundation Bipolar Network. Bipolar Disord. 2003;5:396406.CrossRefGoogle ScholarPubMed
10.Altshuler, LL, Post, RM, Leverich, GS, Mikalauskas, K, Rosoff, A, Ackerman, L. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry. 1995;152:11301138.Google ScholarPubMed
11.Judd, LL, Akiskal, HS, Zeller, PJ, et al.Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry. 2000;57:375380.CrossRefGoogle ScholarPubMed
12.Kocsis, JH, Schatzberg, A, Rush, AJ, et al.Psychosocial outcomes following longterm, double-blind treatment of chronic depression with sertraline vs placebo. Arch Gen Psychiatry. 2002;59:723728.CrossRefGoogle ScholarPubMed
13.Trivedi, MH, Rush, AJ, Crismon, ML, et al.Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project. Arch Gen Psychiatry. 2004;61:669680.CrossRefGoogle ScholarPubMed
14.Badamgarav, E, Weingarten, SR, Henning, JM, et al.Effectiveness of disease management programs in depression: a systematic review. Am J Psychiatry. 2003;160:20802090.CrossRefGoogle ScholarPubMed
15.Melfi, CA, Chawla, AJ, Croghan, TW, Hanna, MP, Kennedy, S, Sredl, K. The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression. Arch Gen Psychiatry. 1998;55:11281132.CrossRefGoogle ScholarPubMed
16.Frank, E, Kupfer, DJ, Perel, JM, et al.Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry. 1990;47:10931099.CrossRefGoogle ScholarPubMed
17.Montgomery, SA, Entsuah, R, Hackett, D, Kunz, NR, Rudolph, RL. Venlafaxine versus placebo in the preventive treatment of recurrent major depression. J Clin Psychiatry. 2004;65:328336.CrossRefGoogle ScholarPubMed
18.Keller, MB, Kocsis, JH, Thase, ME, et al.Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. JAMA. 1998;280:16651672.CrossRefGoogle ScholarPubMed
19.Lustman, PJ, Clouse, RE, Nix, BD, et al.Sertraline for prevention of depression recurrence in diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Arch Gen Psychiatry. 2006;63:521529.CrossRefGoogle ScholarPubMed
20.Mueller, TI, Leon, AC, Keller, MB, et al.Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. Am J Psychiatry. 1999;156:10001006.CrossRefGoogle ScholarPubMed
21.Diagnostic and Statistical Manual of Mental Disorders. 4th ed text rev. Washington, DC: American Psychiatric Association: 2000.Google Scholar
22.Hollon, SD, Shelton, RC, Wisniewski, S, et al.Presenting characteristics of depressed outpatients as a function of recurrence: Preliminary findings from the STAR*D clinical trial. J Psychiatr Res. 2006;40:5969.CrossRefGoogle ScholarPubMed
23.Walker, LG, Heys, SD, Walker, MB, et al.Psychological factors can predict the response to primary chemotherapy in patients with locally advanced breast cancer. Eur J Cancer. 1999;35:17831788.CrossRefGoogle ScholarPubMed
24.Watson, M, Haviland, JS, Greer, S, Davidson, J, Bliss, JM. Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet. 1999;354:13311336.CrossRefGoogle ScholarPubMed
25.Spiegel, D. Cancer and depression. Br J Psychiatry Suppl. 1996;(suppl): 109116.Google Scholar
26.Frasure-Smith, N, Lesperance, F, Juneau, M, Talajic, M, Bourassa, MG. Gender, depression, and one-year prognosis after myocardial infarction. Psychosom Med. 1999;61:2637.CrossRefGoogle ScholarPubMed
27.Penninx, BW, Beekman, AT, Honig, A, et al.Depression and cardiac mortality: results from a community-based longitudinal study. Arch Gen Psychiatry. 2001;58:221227.CrossRefGoogle ScholarPubMed
28.Druss, BG, Rosenheck, RA, Sledge, WH. Health and disability costs of depressive illness in a major U.S. corporation. Am J Psychiatry. 2000;157:12741278.CrossRefGoogle Scholar
29.Reimherr, FW, Strong, RE, Marchant, BK, Hedges, DW, Wender, PH. Factors affecting return of symptoms 1 year after treatment in a 62-week controlled study of fluoxetine in major depression. J Clin Psychiatry. 2001;62(suppl 22):1623.Google Scholar
30.Bockting, CL, Spinhoven, P, Koeter, MW, Wouters, LF, Schene, AH. Prediction of recurrence in recurrent depression and the influence of consecutive episodes on vulnerability for depression: a 2-year prospective study. J Clin Psychiatry. 2006;67:747755.CrossRefGoogle ScholarPubMed
31.Berlanga, C, Heinze, G, Torres, M, Apiquian, R, Caballero, A. Personality and clinical predictors of recurrence of depression. Psychiatr Serv. 1999;50:376380.CrossRefGoogle ScholarPubMed
32.Judd, LL, Akiskal, HS, Maser, JD, et al.Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord. 1998;50:97108.CrossRefGoogle ScholarPubMed
33.Trivedi, MH, Rush, AJ, Wisniewski, SR, et al.Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163:2840.CrossRefGoogle ScholarPubMed
34.Kendler, KS, Thornton, LM, Gardner, CO. Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the “kindling” hypothesis. Am J Psychiatry. 2000;157:12431251.CrossRefGoogle ScholarPubMed
35.Kendler, KS, Thornton, LM, Gardner, CO. Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. Am J Psychiatry. 2001;158:582586.CrossRefGoogle ScholarPubMed
36.Caspi, A, Sugden, K, Moffitt, TE, et al.Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science. 2003;301:386389.CrossRefGoogle ScholarPubMed
37.Sheline, YI. Neuroimaging studies of mood disorder effects on the brain. Biol Psychiatry. 2003;54:338352.CrossRefGoogle ScholarPubMed
38.Campbell, S, Marriott, M, Nahmias, C, MacQueen, GM. Lower hippocampal volume in patients suffering from depression: a meta-analysis. Am J Psychiatry. 2004;161:598607.CrossRefGoogle ScholarPubMed
39.Sheline, YI, Gado, MH, Kraemer, HC. Untreated depression and hippocampal volume loss. Am J Psychiatry. 2003;160:15161518.CrossRefGoogle ScholarPubMed
40.MacQueen, GM, Campbell, S, McEwen, BS, et al.Course of illness, hippocampal function, and hippocampal volume in major depression. Proc Natl Acad Sci USA. 2003;100:13871392.CrossRefGoogle ScholarPubMed