Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T06:35:46.721Z Has data issue: false hasContentIssue false

Self-rated residual symptoms do not predict 1-year recurrence of depression

Published online by Cambridge University Press:  16 April 2020

G. Bertschy*
Affiliation:
Division of adult psychiatry, Department of psychiatry, University Hospitals of Geneva, 2, chemin du Petit-Bel-Air, 1225Chêne-Bourg, Geneva, Switzerland
E. Haffen
Affiliation:
Division of adult psychiatry, University Hospital of Besançon, boulevard Fleming, 25030Besançon, France
N. Gervasoni
Affiliation:
Academic department of psychiatry, University of Geneva and Clinique la Métairie, avenue Bois-Bougy, 1260Nyon, Switzerland
M. Gex-Fabry
Affiliation:
Division of adult psychiatry, Department of psychiatry, University Hospitals of Geneva, 2, chemin du Petit-Bel-Air, 1225Chêne-Bourg, Geneva, Switzerland
C. Osiek
Affiliation:
Division of adult psychiatry, Department of psychiatry, University Hospitals of Geneva, 2, chemin du Petit-Bel-Air, 1225Chêne-Bourg, Geneva, Switzerland
D. Marra
Affiliation:
Division of adult psychiatry, Pitié-Salpêtrière Hospital, 47, boulevard de l’Hôpital, 75634Paris cedex 13, France
J.-M. Aubry
Affiliation:
Division of adult psychiatry, Department of psychiatry, University Hospitals of Geneva, 6–8, rue du 31-Décembre, 1207Geneva, Switzerland
G. Bondolfi
Affiliation:
Division of adult psychiatry, Department of psychiatry, University Hospitals of Geneva, 6–8, rue du 31-Décembre, 1207Geneva, Switzerland
*
*Corresponding author. Tel.: +41 22 305 47 01; fax: +41 22 305 47 69. E-mail address: gilles.bertschy@hcuge.ch (G. Bertschy).
Get access

Abstract

Background

Residual depressive symptoms are generally documented as a risk factor for recurrence. In the absence of a specific instrument for the assessment of residual symptoms, a new 25-item Depression Residual Symptom Scale (DRSS) was elaborated and tested for recurrence prediction over a 1-year follow-up.

Sampling and methods

Fifty-nine patients in remission after a major depressive episode (MDE) were recruited in two centres. They were assessed with the DRSS and the Montgomery-Asberg Depression Rating Scale (MADRS) at inclusion and followed for 1 year according to a seminaturalistic design. The DRSS included specific depressive symptoms and subjective symptoms of vulnerability, lack of return to usual self and premorbid level of functioning.

Results

Severity of residual symptoms was not significantly associated with increased risk of recurrence. However, DRSS score was significantly higher among patients with three or more episodes than one to two episodes. Number of previous episodes and treatment interruption were not identified as significant predictors of recurrence.

Conclusion

The proposed instrument is not predictive of depressive recurrence, but is sensitive to increased perception of vulnerability associated with consecutive episodes. Limitations include small sample size, seminaturalistic design (no standardisation of treatment) and content of the instrument.

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2010

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.)

Footnotes

*

This study was supported in part by a grant of the Swiss National Science Foundation (Grant No. 32-64112.00 to Jean-Michel Aubry, Guido Bondolfi and Gilles Bertschy).

References

Alloy, L.B., Abramson, L.Y., Whitehouse, W.G., Hogan, M.E., Panzarella, C., Rose, D.T.Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression. J Abnorm Psychol 2006;115:145156.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed., text revision ed. Washington, DC: American Psychiatric Association; 2000.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J.An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561571.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., Brown, G.K.Beck Depression Inventory. 2nd ed. San Antonio, TX: The Psychological Corporation; 1996.Google Scholar
Beevers, C.G., Keitner, G.I., Ryan, C.E., Miller, I.W.Cognitive predictors of symptom return following depression treatment. J Abnorm Psychol 2003;112:488496.CrossRefGoogle ScholarPubMed
Bockting, C.L., Spinhoven, P., Koeter, M.W., Wouters, L.F., Schene, A.H.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
Bondolfi, G., Aubry, J.M., Golaz, J., Gex-Fabry, M., Gervasoni, N., Bertschy, G.A stepwise drug treatment algorithm to obtain complete remission in depression: a Geneva study. Swiss Med Wkly 2006;136:7885.Google ScholarPubMed
Booij, L., Van der Does, A.J.Cognitive and serotonergic vulnerability to depression: convergent findings. J Abnorm Psychol 2007;116:8694.CrossRefGoogle ScholarPubMed
Boulenger, J.P.Residual symptoms of depression: clinical and theoretical implications. Eur Psychiatry 2004;19:209213.CrossRefGoogle ScholarPubMed
Cuffel, B.J., Azocar, F., Tomlin, M., Greenfield, S.F., Busch, A.B., Croghan, T.W.Remission, residual symptoms, and nonresponse in the usual treatment of major depression in managed clinical practice. J Clin Psychiatry 2003;64:397402.CrossRefGoogle ScholarPubMed
Dotoli, D., Spagnolo, C., Bongiorno, F., Zanardi, R., Serretti, A., Smeraldi, E.et al. Relapse during a 6-month continuation treatment with fluvoxamine in an Italian population: the role of clinical, psychosocial and genetic variables. Prog Neuropsychopharmacol Biol Psychiatry 2006;30:442448.CrossRefGoogle Scholar
Fabbri, S., Fava, G.A., Rafanelli, C., Tomba, E.Family intervention approach to loss of clinical effect during long-term antidepressant treatment: a pilot study. J Clin Psychiatry 2007;68:13481351.CrossRefGoogle ScholarPubMed
Faravelli, C., Ambonetti, A., Pallanti, S., Pazzagli, A.Depressive relapses and incomplete recovery from index episode. Am J Psychiatry 1986;143:888891.Google ScholarPubMed
Fava, G.A., Grandi, S., Zielezny, M., Canestrari, R., Morphy, M.A.Cognitive behavioral treatment of residual symptoms in primary major depressive disorder. Am J Psychiatry 1994;151:12951299.Google ScholarPubMed
Fava, G.A., Rafanelli, C., Cazzaro, M., Conti, S., Grandi, S.Well-being therapy. A novel psychotherapeutic approach for residual symptoms of affective disorders. Psychol Med 1998;28:475480.CrossRefGoogle ScholarPubMed
Fava, G.A., Ruini, C., Belaise, C.The concept of recovery in major depression. Psychol Med 2007;37:307317.CrossRefGoogle ScholarPubMed
Flint, A.J., Rifat, S.L.Recurrence of first-episode geriatric depression after discontinuation of maintenance antidepressants. Am J Psychiatry 1999;156:943945.CrossRefGoogle ScholarPubMed
Frank, E., Prien, R.F., Jarrett, R.B., Keller, M.B., Kupfer, D.J., Lavori, P.W.et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry 1991;48:851855.CrossRefGoogle ScholarPubMed
Fresco, D.M., Segal, Z.V., Buis, T., Kennedy, S.Relationship of posttreatment decentering and cognitive reactivity to relapse in major depression. J Consult Clin Psychol 2007;75:447455.CrossRefGoogle ScholarPubMed
Geddes, J.R., Carney, S.M., Davies, C., Furukawa, T.A., Kupfer, D.J., Frank, E.et al. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 2003;361:653661.CrossRefGoogle ScholarPubMed
Grunhaus, L., Shipley, J.E., Eiser, A., Pande, A.C., Tandon, R., Remen, A.et al. Shortened REM latency PostECT is associated with rapid recurrence of depressive symptomatology. Biol Psychiatry 1994;36:214222.CrossRefGoogle ScholarPubMed
Hart, A.B., Craighead, W.E., Craighead, L.W.Predicting recurrence of major depressive disorder in young adults: a prospective study. J Abnorm Psychol 2001;110:633643.CrossRefGoogle ScholarPubMed
Hawley, C.J., Gale, T.M., Sivakumaran, T.Defining remission by cut off score on the MADRS: selecting the optimal value. J Affect Disord 2002;72:177184.CrossRefGoogle ScholarPubMed
Healy, D.The assessment of outcome in depression: measures of social functioning. Rev Contemp Pharmacother 2000;11:295301.Google Scholar
Israel, J.A.Remission in depression: definition and initial treatment approaches. J Psychopharmacol 2006;20:510.CrossRefGoogle ScholarPubMed
Keller, M.B., Kocsis, J.H., Thase, M.E., Gelenberg, A.J., Rush, A.J., Koran, L.et al. Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. JAMA 1998;280:16651672.CrossRefGoogle ScholarPubMed
Melartin, T.K., Rytsala, H.J., Leskela, U.S., Lestela-Mielonen, P.S., Sokero, T.P., Isometsa, E.T.Severity and comorbidity predict episode duration and recurrence of DSM-IV major depressive disorder. J Clin Psychiatry 2004;65:810819.CrossRefGoogle ScholarPubMed
Mongrain, M., Leather, F.Immature dependence and self-criticism predict the recurrence of major depression. J Clin Psychol 2006;62:705713.CrossRefGoogle ScholarPubMed
Montgomery, S.A., Asberg, M.A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382389.CrossRefGoogle ScholarPubMed
Paykel, E.S., Ramana, R., Cooper, Z., Hayhurst, H., Kerr, J., Barocka, A.Residual symptoms after partial remission: an important outcome in depression. Psychol Med 1995;25:11711180.CrossRefGoogle ScholarPubMed
Rush, A.J., Trivedi, M.H., Wisniewski, S.R., Nierenberg, A.A., Stewart, J.W., Warden, D.et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 2006;163:19051917.CrossRefGoogle ScholarPubMed
Segal, Z.V., Shaw, B.F., Vella, D.D., Katz, R.Cognitive and life stress predictors of relapse in remitted unipolar depressed patients: test of the congruency hypothesis. J Abnorm Psychol 1992;101:2636.CrossRefGoogle ScholarPubMed
Segal, Z.V., Williams, J.M., Teasdale, J.D., Gemar, M.A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychol Med 1996;26:371380.CrossRefGoogle ScholarPubMed
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E.et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59:2233. quiz 34-57.Google ScholarPubMed
Simons, A.D., Murphy, G.E., Levine, J.L., Wetzel, R.D.Cognitive therapy and pharmacotherapy for depression. Sustained improvement over one year. Arch Gen Psychiatry 1986;43:4348.CrossRefGoogle ScholarPubMed
Teasdale, J.D., Scott, J., Moore, R.G., Hayhurst, H., Pope, M., Paykel, E.S.How does cognitive therapy prevent relapse in residual depression? Evidence from a controlled trial. J Consult Clin Psychol 2001;69:347357.CrossRefGoogle ScholarPubMed
Viguera, A.C., Baldessarini, R.J., Friedberg, J.Discontinuing antidepressant treatment in major depression. Harv Rev Psychiatry 1998;5:293306.CrossRefGoogle ScholarPubMed
Wang, C.E., Brennen, T., Holte, A.Mechanisms of recurrent depression: a cognitive battle model and some preliminary results. Clin Psychol Psychother 2005;12:427442.CrossRefGoogle Scholar
Zimmerman, M., Posternak, M.A., Chelminski, I.Defining remission on the Montgomery-Asberg depression rating scale. J Clin Psychiatry 2004;65:163168.CrossRefGoogle ScholarPubMed
Zimmerman, M., Posternak, M.A., Chelminski, I.Derivation of a definition of remission on the Montgomery-Asberg depression rating scale corresponding to the definition of remission on the Hamilton rating scale for depression. J Psychiatr Res 2004;38:577582.CrossRefGoogle ScholarPubMed
Zimmerman, M., McGlinchey, J.B., Posternak, M.A., Friedman, M., Boerescu, D., Attiullah, N.Differences between minimally depressed patients who do and do not consider themselves to be in remission. J Clin Psychiatry 2005;66:11341138.CrossRefGoogle Scholar
Zimmerman, M., Posternak, M.A., Chelminski, I.Is the cutoff to define remission on the Hamilton Rating Scale for Depression too high?. J Nerv Ment Dis 2005;193:170175.CrossRefGoogle ScholarPubMed
Zimmerman, M., McGlinchey, J.B., Posternak, M.A., Friedman, M., Attiullah, N., Boerescu, D.How should remission from depression be defined? The depressed patient's perspective. Am J Psychiatry 2006;163:148150.CrossRefGoogle ScholarPubMed
Zobel, A.W., Nickel, T., Sonntag, A., Uhr, M., Holsboer, F., Ising, M.Cortisol response in the combined dexamethasone/CRH test as predictor of relapse in patients with remitted depression. a prospective study. J Psychiatr Res 2001;35:8394.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.