Magazine article Clinical Psychiatry News

Initial Depression TX Resistance May Foretell Future. (Long-Term Morbidity Seen)

Magazine article Clinical Psychiatry News

Initial Depression TX Resistance May Foretell Future. (Long-Term Morbidity Seen)

Article excerpt

BOCA RATON, FLA. -- Is initial depression treatment response destiny?

Resistance to initial treatment for depression may indeed predict greater morbidity over the long term: In one study, patients who did not respond to an adequate trial of an antidepressant were signifcantly more likely to have persistent symptoms 15 years later, Dr. William Coryell said at a meeting of the New Clinical Drug Evaluation Unit, sponsored by the National Institute of Mental Health.

Although the association is weaker, good psychosocial functioning in the 5 years before a depressive episode appears to predict superior outcome in the long term, and substantial obsessive and compulsive symptoms during that episode predict a poor outcome, said Dr. Coryell of the University of Iowa, Iowa City.

Dr. Coryell reported an analysis of data from the NIMH Collaborative Program in the Psychobiology of Depression, which included 945 patients, three-fourths of them inpatients, who were treated for major depression, bipolar disorder, or schizoaffective disorder in 1978-1981. Patients were evaluated every 6 months for the next 5 years, and annually thereafter.

One finding of this naturalistic study was that many patients got "surprisingly little treatment, although they continued to have symptoms," he said. …

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