| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Journal of Affective Disorders | ||||
| Verlag: | ELSEVIER SCIENCE BV | ||||
| Ort der Veröffentlichung: | AMSTERDAM | ||||
| Band: | 173 | ||||
| Seitenbereich: | S. 126-133 | ||||
| Datum: | 2015 | ||||
| Institutionen: | Medizin > Lehrstuhl für Psychiatrie und Psychotherapie | ||||
| Identifikationsnummer: |
| ||||
| Stichwörter / Keywords: | BEHAVIORAL-ANALYSIS SYSTEM; RANDOMIZED CONTROLLED-TRIAL; STAR-ASTERISK-D; COMORBIDITY SURVEY REPLICATION; ALGORITHM-GUIDED TREATMENT; FOLLOW-UP; PLUS PHARMACOTHERAPY; DYSTHYMIC DISORDER; CHILDHOOD TRAUMA; MENTAL-HEALTH; Chronic depression; Response; Anti-depressive treatment; German algorithm project | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 60636 |
Web of ScienceZusammenfassung
Background: Approximately 20-30% of patients with Major depressive disorder (MDD) develop a chronic course of their disease. Chronic depression is associated with increased health care utilisation, hospitalisation and a higher disease burden. We identified clinical correlates and differences in treatment response of chronic MDD (cMDD) patients compared with non-chronic episodic depression in a ...
Zusammenfassung
Background: Approximately 20-30% of patients with Major depressive disorder (MDD) develop a chronic course of their disease. Chronic depression is associated with increased health care utilisation, hospitalisation and a higher disease burden. We identified clinical correlates and differences in treatment response of chronic MDD (cMDD) patients compared with non-chronic episodic depression in a huge sample of depressive inpatients. Methods: Data were collected from 412 inpatients who had been diagnosed with a major depressive episode (MDE; according to ICD-10) and scored 15 or higher on the 21-item Hamilton Depression Rating Scale (HRSD-21). All subjects were participants in the German Algorithm Project, phase 3 (GAP3). Patients who were diagnosed with a MDE within the last two years or longer (herein referred to as CD) were compared with non-chronic depressive patients (herein referred to as non-CD). CD and non-CD patients were assessed for the following: psychosocial characteristics, symptom reduction from hospital admission to discharge, symptom severity at discharge, remission and response rates, and pharmacological treatment during inpatient treatment. The primary outcome measure was the HRSD-21. Results: 13.6% (n=56) of patients met the criteria for chronic depression. Compared with non-CD patients, patients with CD showed increased axis l comorbidities (74% vs. 52%, chi(2) (1)=7.31, p=.02), a higher level of depressive symptoms at baseline and discharge, increased duration of inpatient treatment (64.8 vs. 53.3 days; t=2.86, p.03) and lower response (HRSD: 60.0% vs. 72.0%; chi(2) (1)-3.61, p <.04; BDI: 40.5% vs. 54.2%;,chi(2) (1)-3.56, p.04) and remission rates (BDI 17.9.% vs. 29.7%; chi(2) (1)-342, p.05. However, both groups achieved a comparable symptom reduction during inpatient treatment. The prescribed pharmacological strategy had no significant influence on treatment outcome in patients with CD. Conclusion: Inpatients with CD show higher symptom severity, lower response and remission rates and a longer duration of inpatient treatment, although they achieve comparable symptom reduction during treatment. These findings support the need to recognise CD and its defining characteristics as a distinct subclass of depression. (C) 2014 Elsevier B.V. All rights reserved.
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