The four-year course of major depressive disorder: the role of staging and risk factor determination

Lynn Boschloo, Robert A Schoevers, Aartjan T F Beekman, Johannes H Smit, Albert M van Hemert, Brenda W J H Penninx

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Much is still unclear about the mechanisms underlying the course of major depressive disorder (MDD). This study aimed to identify risk factors that predict a poor prognosis of MDD while taking into consideration its chronicity at baseline.

METHODS: In patients with MDD (n = 767), we examined whether baseline clinical factors, sociodemographics, childhood trauma, personality and life events predicted the 4-year course (i.e., sustained recovery, temporary recovery and chronic course) of MDD. Baseline chronicity of MDD was taken into account by testing whether associations were different for patients with nonchronic versus chronic MDD at baseline.

RESULTS: In patients with nonchronic MDD at baseline, 27.8% developed a chronic disorder during follow-up, whereas 53.0% of patients with chronic MDD at baseline had a persistent chronic disorder during follow-up. Severity of MDD, childhood trauma and greater age were important general risk factors for a poor prognosis, independent of MDD chronicity at baseline. In contrast, low extraversion was only important for the course of nonchronic MDD at baseline, while higher education and negative life events (in patients with high neuroticism) were only relevant for the course of chronic MDD at baseline.

CONCLUSIONS: One out of 4 patients with nonchronic MDD progressed to a chronic disorder, while half of the patients with chronic MDD remained chronic during follow-up. Since several risk factors for a poor prognosis differed for patients with nonchronic and chronic MDD at baseline, treatment targets should be adjusted for current chronicity of MDD.

Original languageEnglish
Pages (from-to)279-288
Number of pages10
JournalPsychotherapy and Psychosomatics
Volume83
Issue number5
Early online date6 Aug 2014
DOIs
Publication statusPublished - Aug 2014

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Major Depressive Disorder
Wounds and Injuries
Personality

Keywords

  • Adult
  • Adult Survivors of Child Abuse/psychology
  • Depressive Disorder, Major/diagnosis
  • Disease Progression
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Netherlands/epidemiology
  • Prognosis
  • Psychiatric Status Rating Scales
  • Risk Factors

Cite this

Boschloo, L., Schoevers, R. A., Beekman, A. T. F., Smit, J. H., van Hemert, A. M., & Penninx, B. W. J. H. (2014). The four-year course of major depressive disorder: the role of staging and risk factor determination. Psychotherapy and Psychosomatics, 83(5), 279-288. https://doi.org/10.1159/000362563
Boschloo, Lynn ; Schoevers, Robert A ; Beekman, Aartjan T F ; Smit, Johannes H ; van Hemert, Albert M ; Penninx, Brenda W J H. / The four-year course of major depressive disorder : the role of staging and risk factor determination. In: Psychotherapy and Psychosomatics. 2014 ; Vol. 83, No. 5. pp. 279-288.
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abstract = "BACKGROUND: Much is still unclear about the mechanisms underlying the course of major depressive disorder (MDD). This study aimed to identify risk factors that predict a poor prognosis of MDD while taking into consideration its chronicity at baseline.METHODS: In patients with MDD (n = 767), we examined whether baseline clinical factors, sociodemographics, childhood trauma, personality and life events predicted the 4-year course (i.e., sustained recovery, temporary recovery and chronic course) of MDD. Baseline chronicity of MDD was taken into account by testing whether associations were different for patients with nonchronic versus chronic MDD at baseline.RESULTS: In patients with nonchronic MDD at baseline, 27.8{\%} developed a chronic disorder during follow-up, whereas 53.0{\%} of patients with chronic MDD at baseline had a persistent chronic disorder during follow-up. Severity of MDD, childhood trauma and greater age were important general risk factors for a poor prognosis, independent of MDD chronicity at baseline. In contrast, low extraversion was only important for the course of nonchronic MDD at baseline, while higher education and negative life events (in patients with high neuroticism) were only relevant for the course of chronic MDD at baseline.CONCLUSIONS: One out of 4 patients with nonchronic MDD progressed to a chronic disorder, while half of the patients with chronic MDD remained chronic during follow-up. Since several risk factors for a poor prognosis differed for patients with nonchronic and chronic MDD at baseline, treatment targets should be adjusted for current chronicity of MDD.",
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The four-year course of major depressive disorder : the role of staging and risk factor determination. / Boschloo, Lynn; Schoevers, Robert A; Beekman, Aartjan T F; Smit, Johannes H; van Hemert, Albert M; Penninx, Brenda W J H.

In: Psychotherapy and Psychosomatics, Vol. 83, No. 5, 08.2014, p. 279-288.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - The four-year course of major depressive disorder

T2 - the role of staging and risk factor determination

AU - Boschloo, Lynn

AU - Schoevers, Robert A

AU - Beekman, Aartjan T F

AU - Smit, Johannes H

AU - van Hemert, Albert M

AU - Penninx, Brenda W J H

PY - 2014/8

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N2 - BACKGROUND: Much is still unclear about the mechanisms underlying the course of major depressive disorder (MDD). This study aimed to identify risk factors that predict a poor prognosis of MDD while taking into consideration its chronicity at baseline.METHODS: In patients with MDD (n = 767), we examined whether baseline clinical factors, sociodemographics, childhood trauma, personality and life events predicted the 4-year course (i.e., sustained recovery, temporary recovery and chronic course) of MDD. Baseline chronicity of MDD was taken into account by testing whether associations were different for patients with nonchronic versus chronic MDD at baseline.RESULTS: In patients with nonchronic MDD at baseline, 27.8% developed a chronic disorder during follow-up, whereas 53.0% of patients with chronic MDD at baseline had a persistent chronic disorder during follow-up. Severity of MDD, childhood trauma and greater age were important general risk factors for a poor prognosis, independent of MDD chronicity at baseline. In contrast, low extraversion was only important for the course of nonchronic MDD at baseline, while higher education and negative life events (in patients with high neuroticism) were only relevant for the course of chronic MDD at baseline.CONCLUSIONS: One out of 4 patients with nonchronic MDD progressed to a chronic disorder, while half of the patients with chronic MDD remained chronic during follow-up. Since several risk factors for a poor prognosis differed for patients with nonchronic and chronic MDD at baseline, treatment targets should be adjusted for current chronicity of MDD.

AB - BACKGROUND: Much is still unclear about the mechanisms underlying the course of major depressive disorder (MDD). This study aimed to identify risk factors that predict a poor prognosis of MDD while taking into consideration its chronicity at baseline.METHODS: In patients with MDD (n = 767), we examined whether baseline clinical factors, sociodemographics, childhood trauma, personality and life events predicted the 4-year course (i.e., sustained recovery, temporary recovery and chronic course) of MDD. Baseline chronicity of MDD was taken into account by testing whether associations were different for patients with nonchronic versus chronic MDD at baseline.RESULTS: In patients with nonchronic MDD at baseline, 27.8% developed a chronic disorder during follow-up, whereas 53.0% of patients with chronic MDD at baseline had a persistent chronic disorder during follow-up. Severity of MDD, childhood trauma and greater age were important general risk factors for a poor prognosis, independent of MDD chronicity at baseline. In contrast, low extraversion was only important for the course of nonchronic MDD at baseline, while higher education and negative life events (in patients with high neuroticism) were only relevant for the course of chronic MDD at baseline.CONCLUSIONS: One out of 4 patients with nonchronic MDD progressed to a chronic disorder, while half of the patients with chronic MDD remained chronic during follow-up. Since several risk factors for a poor prognosis differed for patients with nonchronic and chronic MDD at baseline, treatment targets should be adjusted for current chronicity of MDD.

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KW - Adult Survivors of Child Abuse/psychology

KW - Depressive Disorder, Major/diagnosis

KW - Disease Progression

KW - Female

KW - Humans

KW - Interview, Psychological

KW - Male

KW - Netherlands/epidemiology

KW - Prognosis

KW - Psychiatric Status Rating Scales

KW - Risk Factors

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DO - 10.1159/000362563

M3 - Article

VL - 83

SP - 279

EP - 288

JO - Psychotherapy and Psychosomatics

JF - Psychotherapy and Psychosomatics

SN - 0033-3190

IS - 5

ER -