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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Stability of remission rates in a 3-year follow-up of naturalistic treated depressed inpatients

Authors: Florian Seemüller, Michael Obermeier, Rebecca Schennach, Michael Bauer, Mazda Adli, Peter Brieger, Gerd Laux, Michael Riedel, Peter Falkai, Hans-Jürgen Möller

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Remission is a common outcome of short-term trials and the main goal of acute and longterm treatment. The longitudinal stability of remission has rarely been investigated under naturalistic treatment conditions.

Methods

Naturalistic multisite follow-up study. Three-year symptomatic long-term outcome of initially hospitalized tertiary care patients (N = 784) with major depressive episodes. Remission rates as well as the switch rates between remission and non-remission were reported.

Results

After one, two and three years 62 %, 59 % and 69 % of the observed patients met criteria for remission. During the follow-up 88 % of all patients achieved remission. 36 % of maintained remission from discharge to 3-years, 12 % of all patients never reached remission and 52 % percent showed a fluctuating course switching from remission to non-remission and vice versa. There was considerable transition between remission and non-remission. For example, from discharge to 1 year, from 1 to 2, and from 2 to 3 years 25 %, 21 % and 11 % lost remission.

Conclusion

Cumulative outcome rates are encouraging. Absolute rates at predefined endpoints as well as the fluctuations between these outcomes reflect the variable and chronic nature of major depression.
Literature
1.
2.
Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, Rush AJ, Weissman MM. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991;48:851–5.CrossRefPubMed
3.
Möller H-J. Outcomes in major depressive disorder: the evolving concept of remission and its implications for treatment. World J Biol Psychiatry Off J World Fed Soc Biol Psychiatry. 2008;9:102–14.CrossRef
4.
Holma KM, Holma IA, Melartin TK, Rytsala HJ, Isometsa ET. Long-term outcome of major depressive disorder in psychiatric patients is variable. J Clin Psychiatry. 2008;69:196–205.CrossRefPubMed
5.
Naz B, Craig TJ, Bromet EJ, Finch SJ, Fochtmann LJ, Carlson GA. Remission and relapse after the first hospital admission in psychotic depression: a 4-year naturalistic follow-up. Psychol Med. 2007;37:1173–81.CrossRefPubMed
6.
Ramana R, Paykel ES, Cooper Z, Hayhurst H, Saxty M, Surtees PG. Remission and relapse in major depression: a two-year prospective follow-up study. Psychol Med. 1995;25:1161–70.CrossRefPubMed
7.
O’Leary D, Costello F, Gormley N, Webb M. Remission onset and relapse in depression. An 18-month prospective study of course for 100 first admission patients. J Affect. 2000;57:159–71.CrossRef
8.
Keller MB, Lavori PW, Mueller TI, Endicott J, Coryell W, Hirschfeld RM, Shea T. Time to recovery, chronicity, and levels of psychopathology in major depression. A 5-year prospective follow-up of 431 subjects. Arch Gen Psychiatry. 1992;49:809–16.CrossRefPubMed
9.
Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet Lond Engl. 2003;361:653–61.CrossRef
10.
Seemüller F, Meier S, Obermeier M, Musil R, Bauer M, Adli M, Kronmüller K, Holsboer F, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Riedel M, Falkai P, Möller H-J. Three-Year long-term outcome of 458 naturalistically treated inpatients with major depressive episode: severe relapse rates and risk factors. Eur Arch Psychiatry Clin Neurosci. 2014;264:567–75.CrossRefPubMed
11.
van der Voort TYG, Seldenrijk A, van Meijel B, Goossens PJJ, Beekman ATF, Penninx BWJH, et al. Functional versus syndromal recovery in patients with major depressive disorder and bipolar disorder. J. Clin. Psychiatry. 2015;76:e809–814.CrossRefPubMed
12.
Lee AS, Murray RM. The long-term outcome of Maudsley depressives. Br J Psychiatry. 1988;153:741–51.CrossRefPubMed
13.
Kennedy N, Abbott R, Paykel ES. Remission and recurrence of depression in the maintenance era: long-term outcome in a Cambridge cohort. Psychol Med. 2003;33:827–38.CrossRefPubMed
14.
Seemüller F, Riedel M, Obermeier M, Bauer M, Adli M, Kronmüller K, Holsboer F, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Dichgans E, Bottländer R, Musil R, Möller H-J. Outcomes of 1014 naturalistically treated inpatients with major depressive episode. Eur Neuropsychopharmacol J Eur Coll Neuropsychopharmacol. 2010;20:346–55.CrossRef
15.
Henkel V, Seemüller F, Obermeier M, Adli M, Bauer M, Mundt C, et al. Does early improvement triggered by antidepressants predict response/remission? — Analysis of data from a naturalistic study on a large sample of inpatients with major depression. J. Affect. Disord. 2009;115:439–49.
16.
Fydrich H-UWMZT: SKID Strukturiertes Klinisches Interview für DSM-IV. Hogrefe. Göttingen, Germany; 1997.
17.
Schwab JJ, Bialow MR, Clemmons RS, Holzer CE. Hamilton rating scale for depression with medical in-patients. Br J Psychiatry J Ment Sci. 1967;113:83–8.CrossRef
18.
Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–9.CrossRefPubMed
19.
Cording C, Gaebel W, Spengler A: Die neue psychiatrische Basisdokumentation. Eine Empfehlung der DGPPN zur Qualitätssicherung im (teil-) station„ren Bereich. [The new psychiatric basic documentation. A recommendation by the DGPPN for quality assurance in inpatient treatment]. Spektrum Psychiatr Nervenheilkd 1995;24:3–41.
20.
Riedel M, Möller H-J, Obermeier M, Schennach-Wolff R, Bauer M, Adli M, Kronmüller K, Nickel T, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Seemüller F. Response and remission criteria in major depression--a validation of current practice. J Psychiatr Res. 2010;44:1063–8.CrossRefPubMed
21.
22.
Akerblad A-C, Bengtsson F, von Knorring L, Ekselius L. Response, remission and relapse in relation to adherence in primary care treatment of depression: a 2-year outcome study. Int Clin Psychopharmacol. 2006;21:117–24.CrossRefPubMed
23.
Vuorilehto MS, Melartin TK, Rytsälä HJ, Isometsä ET. Do characteristics of patients with major depressive disorder differ between primary and psychiatric care? Psychol Med. 2007;37:893–904.CrossRefPubMed
24.
Alexopoulos GS, Reynolds 3rd CF, Bruce ML, Katz IR, Raue PJ, Mulsant BH, Oslin DW, Ten Have T, PROSPECT Group. Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study. Am J Psychiatry. 2009;166:882–90.CrossRefPubMedPubMedCentral
25.
Seemüller F, Möller H-J, Obermeier M, Adli M, Bauer M, Kronmüller K, Holsboer F, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Schennach-Wolff R, Henkel V, Riedel M. Do efficacy and effectiveness samples differ in antidepressant treatment outcome? An analysis of eligibility criteria in randomized controlled trials. J Clin Psychiatry. 2010;71:1425–33.CrossRefPubMed
26.
Zimmerman M, Mattia JI, Posternak MA. Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice? Am J Psychiatry. 2002;159:469–73.CrossRefPubMed
27.
Rush AJ, Trivedi MH, Stewart JW, Nierenberg AA, Fava M, Kurian BT, Warden D, Morris DW, Luther JF, Husain MM, Cook IA, Shelton RC, Lesser IM, Kornstein SG, Wisniewski SR. Combining medications to enhance depression outcomes (CO-MED): acute and long-term outcomes of a single-blind randomized study. Am J Psychiatry. 2011;168:689–701.CrossRefPubMed
28.
Thase ME, Gelenberg A, Kornstein SG, Kocsis JH, Trivedi MH, Ninan P, et al. Comparing venlafaxine extended release and fluoxetine for preventing the recurrence of major depression: results from the PREVENT study. J. Psychiatr. Res. 2011;45:412–20
29.
Spijker J, de Graaf R, Bijl RV, Beekman ATF, Ormel J, Nolen WA. Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Br J Psychiatry J Ment Sci. 2002;181:208–13.CrossRef
30.
Pampallona S, Bollini P, Tibaldi G, Kupelnick B, Munizza C. Patient adherence in the treatment of depression. Br J Psychiatry J Ment Sci. 2002;180:104–9.CrossRef
31.
32.
Stegenga BT, Kamphuis MH, King M, Nazareth I, Geerlings MI. The natural course and outcome of major depressive disorder in primary care: the PREDICT-NL study. Soc Psychiatry Psychiatr Epidemiol. 2012;47:87–95.CrossRefPubMed
33.
Frank E, Kupfer DJ, Perel JM, Cornes C, Jarrett DB, Mallinger AG, Thase ME, McEachran AB, Grochocinski VJ. Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry. 1990;47(12):1093–9.CrossRefPubMed
34.
Warden D, Rush AJ, Carmody TJ, Kashner TM, Biggs MM, Crismon ML, Trivedi MH. Predictors of attrition during one year of depression treatment: a roadmap to personalized intervention. J Psychiatr Pract. 2009;15:113–24.CrossRefPubMedPubMedCentral
35.
Gervasoni N, Legendre-Simon P, Aubry J-M, Gex-Fabry M, Bertschy G, Bondolfi G. Early telephone intervention for psychiatric outpatients starting antidepressant treatment. Nord J Psychiatry. 2010;64:265–7.CrossRefPubMed
36.
Warden D, Rush AJ, Wisniewski SR, Lesser IM, Kornstein SG, Balasubramani GK, Thase ME, Preskorn SH, Nierenberg AA, Young EA, Shores-Wilson K, Trivedi MH. What predicts attrition in second step medication treatments for depression?: a STAR*D Report. Int J Neuropsychopharmacol Off Sci J Coll Int Neuropsychopharmacol CINP. 2009;12:459–73.
37.
Sabaté E, Organization WH: Adherence to Long-Term Therapies: Evidence for Action. Germany: World Health Organization; 2003.
38.
Prukkanone B, Vos T, Burgess P, Chaiyakunapruk N, Bertram M. Adherence to antidepressant therapy for major depressive patients in a psychiatric hospital in Thailand. BMC Psychiatry. 2010;10:64.CrossRefPubMedPubMedCentral
39.
Kennedy GJ, Kelman HR, Thomas C. Persistence and remission of depressive symptoms in late life. Am J Psychiatry. 1991;148:174–8.CrossRefPubMed
40.
Molnar FJ, Man-Son-Hing M, Hutton B, Fergusson DA. Have last-observation-carried-forward analyses caused us to favour more toxic dementia therapies over less toxic alternatives? A systematic review. Open Med Peer-Rev Indep Open-Access J. 2009;3:e31–50.
41.
Prakash A, Risser RC, Mallinckrodt CH. The impact of analytic method on interpretation of outcomes in longitudinal clinical trials. Int J Clin Pract. 2008;62:1147–58.CrossRefPubMedPubMedCentral
Metadata
Title
Stability of remission rates in a 3-year follow-up of naturalistic treated depressed inpatients
Authors
Florian Seemüller
Michael Obermeier
Rebecca Schennach
Michael Bauer
Mazda Adli
Peter Brieger
Gerd Laux
Michael Riedel
Peter Falkai
Hans-Jürgen Möller
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0851-4

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