Clinical Psychology
and Psychotherapy

Clinical Psychology and Psychotherapy

Depressive Disorders: Course

Depressive disorders often appear in recurrent episodes or in phases, with a high rate of recurrence in untreated individuals. Under adequate, multi-stage treatment can about 2/3 of all outpatients with major depression achieve long term remission (cf. Rush 2006).

The risk of recurrence or relapse is particularly enhanced if the victims suffer from bipolar affective disorder, double depression or comorbid anxiety disorders or addiction problems, if the disease first appeared at a very early age and / or if the patients responded badly on the previous therapy (cf. Rush 2006).

The duration of depressive episodes can vary from a few weeks to long episodes of more than one year in duration. Untreated, the episode duration is on average about 6 to 8 months.

About two thirds of the affected premenopausal women report premenstrual worsening of their depressive symptoms (cf. Kornstein 2005).

The risk for a severe course of depression increases with advanced age and in unfavorable family and social conditions such as lack of support and continuous problems and conflicts. A genetic load with multiple diseased blood relatives also increases the risk for a severe course.

In addition the existence of other diseases, such as an obsessive-compulsive disorder, eating disorder, post traumatic stress disorder or an alcohol or drug dependency may complicate the course of depression. Certain personality styles, such as histrionic or narcissistic personality disorders may complicate the course.

There are studies that suggest a link between genetic variations in the serotonin 2A receptor and the success of treatment with SSRIs (cf. McMahon 2006).

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 

Further Reading...

 

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References

Depressive Disorders: Course

Kornstein SG, Harvey AT, Rush AJ, Wisniewski SR, Trivedi MH, Svikis DS, McKenzie ND, Bryan C, Harley R (2005). Self-reported premenstrual exacerbation of depressive symptoms in patients seeking treatment for major depression. Psychol Med 35(5): 683-92.
Abstract >>

McMahon FJ, Buervenich S, Charney D, Lipsky R, Rush AJ, Wilson AF, Sorant AJ, Papanicolaou GJ, Laje G, Fava M, Trivedi MH, Wisniewski SR, Manji H (2006). Variation in the gene encoding the serotonin 2A receptor is associated with outcome of antidepressant treatment. Am J Hum Genet 78(5): 804-14.
Abstract >>

Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackeim HA, Kupfer DJ, Luther J, Fava M (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 163(11): 1905-17.
Abstract >>

Depressive Disorders: Guidelines
 

American Psychiatric Association - APA (2010). Practice Guideline for the treatment of patients with major depressive disorder. 3rd edition. Arlington: APPI.

DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (Hrsg) für die Leitliniengruppe Unipolare Depression (2009). S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression - Kurzfassung, 1. Auflage. Berlin, Düsseldorf: DGPPN, ÄZQ, AWMF.
Online-Version >>

National Institute for Health an Clinical Excellence - NICE (Hrsg) (2009). Depression - The treatment and management of depression in adults. Clinical guideline 90. London: NICE.
Online-Version >>

National Institute for Health an Clinical Excellence - NICE (2003). Guidance on the use of electroconvulsive therapy. Technology Appraisal Guideline 59. London: NICE.
Online-Version >>

 

Depressive Störungen: Verlauf  Depressive Disorders: Course  Depressive Disorders: Course

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 




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© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.org
Last updated: 03-24-2016
 

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