Duration of untreated depression influences clinical outcomes and disability

JOURNAL OF AFFECTIVE DISORDERS

卷:175

Article

Ghio, Lucio¹  Gotelli, Simona²  Cervetti, Alice¹  Respino, Matteo¹  Natta, Werner¹  Marcenaro, Maurizio¹  Serafini, Gianluca¹  Vaggi, Marco²  Amore, Mario¹  Murri, Martino Belvederi¹ 

[1] Univ Genoa, Psychiat Sect, Dept Neurosci Ophthalmol & Genet, I-16126 Genoa, Italy

[2] ASL3, Dept Mental Hlth, Genoa, Italy

关键词: Depression;    Untreated illness;    Antidepressant;    Prevention;    Early intervention;    Disability;   

DOI  :  10.1016/j.jad.2015.01.014

来源: Elsevier

【 摘 要 】

Background: The duration of untreated depression (DUD) might have a substantial impact on the clinical outcomes; however, there are important knowledge gaps including the effects on disability and potential differences between first-episode and recurrent episodes of depression. Methods: We recruited 121 outpatients with first episode and recurrent major depression, and conducted prospective clinical assessments over six months. Clinical outcomes included response to antidepressant therapy, remission and changes in disability. Results: Patients with a DUD of six months or shorter were more frequently young, unemployed and had higher levels of physical illnesses than those with a longer DUD (all p < 0.05). A shorter DUD was associated with significantly higher odds of response at 12 weeks (adjusted odds ratio 2.8; 95%, CI: 12-68) and remission at 24 weeks (4.1; 95% CI: 1.6-10.5) after adjusting for relevant confounders. Changes in disability ratings were analyzed with growth curve analysis and showed steeper declines among those with a shorter DUD. The associations of DUD on clinical outcomes were evident both in patients with first-episode and recurrent depression. Limitations: Naturalistic design. Self-rated assessment of disability. Findings from subgroup analyses should be replicated in larger sample size. Conclusions: A shorter duration of untreated depression is associated with more favorable outcomes for major depression, including depression related disability. This association seems to work both at the first and recurrent episodes, which might have direct implications for both primary and secondary prevention. (C) 2015 Elsevier B.V. All rights reserved.

【 授权许可】

Free