Factors associated with outcome in major depression: a 6-month prospective study |
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Authors: | E Ezquiaga A García F Bravo T Pallarés |
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Affiliation: | (1) Department of Psychiatry, La Princesa University Hospital, Diego de León 62, E-28006 Madrid, Spain, ES;(2) Regional Health Service, Comunidad Autónoma de Madrid, Madrid, Spain, ES |
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Abstract: | A number of authors have indicated in recent years that the course of depression is not as favourable as previously expected.
Research conducted in order to identify predictors of recovery has shown widely different results. In this paper a sample
of 90 consecutive patients with non-chronic major depressive disorders (index episode <6 months) attending four mental health
centres in Madrid were followed up prospectively for 6 months, and clinical social and cognitive variables were studied. The
patients were treated pharmacologically and controlled. The rate of recovery was measured according to the Hamilton Rating
Scale for Depression (HAM-D). Other tools used were: Life Events and Chronic Difficulties, Global Assessment Functioning in
the 6 months prior to the onset of episode, Brown Rating Scale for Self-Esteem and Mannheim Interview of Social Support. The
results showed that 41 cases recovered (HAM-D score <8), 29 cases achieved a partial remission, and major depressive disorder
persisted in 17 cases (HAM-D score ≥18). The presence of personality disorders, having suffered a previous episode, GAF score
and some aspects of social support were the variables most associated with non full remission in the logistic regression analysis.
Personality disorders and the initial HAM-D score were related to non-improvement. Some clinical and cognitive variables maintain
a weak relation to outcome and are rejected in logistic regression. This study emphasizes the relationship of personality,
and social variables such as social support and previous global functioning, with incomplete recovery in major depression.
Accepted: 11 May 1998 |
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