G. FASSONE, V. TRINCIA, A. D’AMATO, M. PASQUINI, A. PICARDI, M. BIONDI, P. PANCHERI, P. PASQUINI - Vol. 9, March 2003, Issue 1
Testo Immagini Bibliografia Summary Indice
Studio di follow-up a 2 anni nei disturbi
depressivi unipolari: risultati preliminari su 70 pazienti
A 2-year follow-up study of patients with unipolar depressive disorders:
preliminary findings on 70 patients
Introduction
Outcome studies on unipolar depression show high rate of relapses and
a substantial risk of chronicity. Available data underline that prolonged
remission from symptoms is the exception rather than the rule for the majority
of depressed patients.
Methods
The aim of this study was to evaluate the long-term course and outcome
in unipolar depressive disorders with a 2-year follow-up assessment, using
a telephone clinical interview which included the GAF and a reduced version
of the HAM-D.
Results
Data on the first 70 subjects (32 male, 38 female) who were included in
the study are presented. During the first year, 26% dropped out soon after
the first visit while 24% dropped out before being appropriately taken in
charge by the psychiatric service. Only 13% showed a satisfactory course at
the end of first 12 months. Eighty-seven percent of subjects who signed informed
consent for the follow-up (47/54) were contacted after 2 years. Fifty-one
percent of patients had a recurrence, while 47% had a HAM-D score>5 at
the follow-up interview. As compared to patients with HAM-D < 5,
patients with HAM-D > 5 had worse social functioning (GAF 62 vs. 85, p
< .001), reported a higher number (2.9 vs. 0.1, p < .001) and longer
duration (5.7 vs. 0.8 months, p =. 02) of relapses during the follow-up period.
Multiple logistic regression analysis showed that female gender and having
a bad psychosocial functioning at baseline were significantly associated with
the presence of depressive symptoms after two years.
Conclusion
Despite effective antidepressant treatment was appropriately prescribed
to most patients, long-term outcome is still unsatisfactory, given that more
than half of the sample had relapses and 47% still show residual depressive
symptoms after two years. These preliminary data provide some hints about
factors associated with poor outcome, that nevertheless will have to be extensively
evaluated on the entire study sample.