Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-05-25T03:53:48.130Z Has data issue: false hasContentIssue false
  • English
  • Français

May duration of untreated illness influence the long-term course of major depressive disorder?

Published online by Cambridge University Press:  16 April 2020

A. Carlo Altamura ,
Bernardo Dell'Osso ,
Serena Vismara  and
Emanuela Mundo
A. Carlo Altamura*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milano, Italy
Bernardo Dell'Osso
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milano, Italy
Serena Vismara
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milano, Italy
Emanuela Mundo
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milano, Italy
*
*Corresponding author. Tel.: +39 02 39042948; fax: +39 02 39042510. E-mail address: carlo.altamura@policlinico.mi.it (A.C. Altamura).
Get access

Abstract

The aim of this naturalistic study was to investigate the possible influence of the duration of untreated illness (DUI) on the long-term course of Major Depressive Disorder (MDD). One hundred and thirteen patients with recurrent MDD, according to DSM-IV-TR criteria, followed up for 5 years, were selected, interviewed and their clinical charts were reviewed. The DUI was defined as the interval between the onset of the first depressive episode and the first adequate antidepressant treatment. The sample was divided into two groups according to the DUI: one group with a DUI ≤ 12 months (n = 75), and the other with a DUI > 12 months (n = 38). The main demographic and clinical course variables were compared between the two groups using Student's t-tests or chi-square tests. Patients with a longer DUI showed an earlier age at onset (t = 2.82, p = 0.006) and a longer duration of illness (t = 3.20, p = 0.002) compared to patients with a shorter DUI. In addition, the total number of depressive episodes occurring before the first antidepressant treatment was higher in the group with a longer DUI (t = −2.223, p < 0.03). Even though limited by the retrospective nature of the study, these preliminary findings would suggest that a longer DUI may negatively influence the course of MDD. Larger prospective studies are warranted to further investigate the role of the DUI within MDD.

Keywords

Duration of untreated illness (DUI)Major depressive disorder (MDD)Long-term course
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 2 , March 2008 , pp. 92 - 96
Copyright
Copyright © Elsevier Masson SAS 2008

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.)

References

Altamura, A.C., Bassetti, R., Sassella, F., Salvadori, D., Mundo, E.Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study. Schizophrenia Research 2001;52(1–2):29–36.CrossRefGoogle ScholarPubMed
Altamura, A.C., Bassetti, R., Bigotti, S., Pioli, R., Mundo, E.Clinical variables related to suicide attempts in schizophrenic patients: a retrospective study. Schizophrenia Research 2003;60(1):47–55.CrossRefGoogle ScholarPubMed
Altamura, A.C., Santini, A., Salvadori, D., Mundo, E.Duration of untreated illness in panic disorder: a poor outcome risk factor? Neuropsychiatric Disease and Treatment 2005;1(4):345–347.Google ScholarPubMed
Altamura, A.C., Dell'Osso, B., Mundo, E., Dell'Osso, L.Duration of untreated illness in major depressive disorder: a naturalistic study. International Journal of Clinical Practice 2007;61(10):1697–1700.CrossRefGoogle ScholarPubMed
American Psychiatric Association, Diagnostic and statistical manual of mental disorders. [text revision]4th ed.Washington, DC: American Psychiatric Association; 2000.Google Scholar
American Psychiatric Association, Practice guidelines for the treatment of psychiatric disorders. [compendium] Arlington, VA: American Psychiatric Association; 2006. p. 441–525.CrossRefGoogle Scholar
Baethge, C., Gruschka, P., Smolka, M.N., Berghofer, A., Bschor, T., Muller-Oerlinghausen, B.et al.Effectiveness and outcome predictors of long-term lithium prophylaxis in unipolar major depressive disorder. Journal of Psychiatry & Neuroscience 2003;28(5):355–361.Google ScholarPubMed
Baethge, C., Tondo, L., Bratti, I.M., Bschor, T., Bauer, M., Viguera, A.C.et al.Prophylaxis latency and outcome in bipolar disorders. Canadian Journal of Psychiatry 2003;48(7):449–457.CrossRefGoogle ScholarPubMed
Bottlender, R., Sato, T., Jager, M., Wegener, U., Wittmann, J., Strauss, A.et al.The impact of the duration of untreated psychosis prior to first psychiatric admission on the 15-year outcome in schizophrenia. Schizophrenia Research 2003;62(1–2):37–44.CrossRefGoogle Scholar
Craig, T.J., Bromet, E.J., Fennig, S., Tanenberg-Karant, M., Lavelle, J., Galambos, N.et al.Is there an association between duration of untreated psychosis and 24-month clinical in first admission series? American Journal of Psychiatry 2000;157:60–66.CrossRefGoogle ScholarPubMed
Crow, T.J., McMillan, J.F., Johnson, A.L., Johnstone, E.C.A randomized controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry 1986;148:120–127.CrossRefGoogle ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W.Structured clinical interview for DSM-IV Axis I (SCID-I). [clinician version] Washington DC: American Psychiatric Press; 1997.Google Scholar
Goldberg, J.F., Ernst, C.L.Features associated with the delayed initiation of mood stabilizers at illness onset in bipolar disorder. Journal of Clinical Psychiatry 2002;63(11):985–991.CrossRefGoogle ScholarPubMed
Gollan, J., Raffety, B., Gortner, E., Dobson, K.Course profiles of early- and adult-onset depression. Journal of Affective Disorders 2005;86(1):81–86.CrossRefGoogle ScholarPubMed
Gormley, N., O'Leary, D., Costello, F.First admission for depression: is the “no-treatment interval” a critical predictor of time to remission? Journal of Affective Disorders 1999;54(1–2):49–54.CrossRefGoogle ScholarPubMed
Hamilton, M.A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
Ho, B.C., Andreasen, A.C., Flaum, M., Nopoulos, P., Miller, D.Untreated initial psychosis: its relation to quality of life and symptom remission in first-episode schizophrenia. American Journal of Psychiatry 2000;157:808–815.CrossRefGoogle ScholarPubMed
Klein, D.N.Depressive personality in the relatives of outpatients with dysphoric disorder and episodic major depressive disorder and normal controls. Journal of Affective Disorders 1999;55(1):19–27.CrossRefGoogle Scholar
Loebel, A.D., Lieberman, J.A., Alvir, J.M., Mayerhoff, D.I., Geisler, S.H., Szymanski, S.R.Duration of psychosis and outcome in first episode schizophrenia. American Journal of Psychiatry 1992;149:1183–1188.Google ScholarPubMed
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., Croudace, T.Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Archives of General Psychiatry 2005;62(9):975–983.CrossRefGoogle ScholarPubMed
McGlashan, T.H.Predictors of short, medium and long-term outcome in schizophrenia. American Journal of Psychiatry 1986;143(1):50–55.Google Scholar
Mundo, E., Santini, A., Salvadori, D., Altamura, A.C. Duration of untreated illness (DUI) and clinical course in bipolar disorder [abstract]. Presented at the 158th American Psychiatric Association annual meeting, May 21–26, 2005, Atlanta, GA, USA.Google Scholar
Norrholm, S.D., Ouimet, C.C.Altered dendritic spine density in animal models of depression and in response to antidepressant treatment. Synapse 2001;42:151–163.CrossRefGoogle ScholarPubMed
Olney, J.W., Farber, N.B.Glutamate receptor dysfunction and schizophrenia. Archives of General Psychiatry 1995;52:998–1007.CrossRefGoogle Scholar
Rund, B.R., Melle, I., Friis, S., Larsen, T., Midboe, L.J., Opjordsmoen, S.et al.Neurocognitive dysfunction in first episode psychosis: correlates with symptoms, premorbid adjustment, and duration of untreated psychosis. American Journal of Psychiatry 2004;1613:466–472.CrossRefGoogle Scholar
Sareen, J., Jagdeo, A., Cox, B.J., Clara, I., ten Have, M., Belik, S.L.et al.Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatric Services 2007;58(3):357–364.CrossRefGoogle ScholarPubMed
Scott, J., Eccleston, D., Boys, R.Can we predict the persistence of depression? British Journal of Psychiatry 1992;161:633–637.CrossRefGoogle ScholarPubMed
Theberge, J., Al-Semaan, Y., Drost, D.J., Malla, A.K., Neufeld, R.W., Bartha, R.et al.Duration of untreated psychosis vs. N-acetylaspartate and choline in first episode schizophrenia: a 1H magnetic resonance spectroscopy study at 4.0 tesla. Psychiatry Research 2004;131:107–114.CrossRefGoogle ScholarPubMed
Ucok, A., Polat, A., Genc, A., Cakir, S., Turan, N.Duration of untreated psychosis may predict acute treatment response in first-episode schizophrenia. Journal of Psychiatry Research 2004;38(2):163–168.CrossRefGoogle ScholarPubMed
Videbech, P., Ravnkilde, B.Hippocampal volume and depression. A meta-analysis of MRI studies. American Journal of Psychiatry 2004;161:1957–1966.CrossRefGoogle ScholarPubMed
Winokur, G., Coryell, W., Keller, M., Endicott, J., Akiskal, H.A prospective follow-up of patients with bipolar and primary unipolar affective disorder. Archives of General Psychiatry 1993;50(6):457–465.CrossRefGoogle ScholarPubMed
Wyatt, R.J.Early intervention for schizophrenia. Can be the course of the illness be altered? Biological Psychiatry 1995;38:1–3.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.