Skip to main content Accessibility help

Psychiatric outcomes 10 years after treatment with antidepressants or anxiolytics

  • Ian Colman (a1), Tim J. Croudace (a2), Michael E. J. Wadsworth (a3), Diana Kuh (a3) and Peter B. Jones (a2)...



Antidepressants and anxiolytics have demonstrated short-term efficacy; however, little is known about the long-term effectiveness of these drugs.


To investigate long-term psychiatric outcomes following antidepressant and/or anxiolytic use during an episode of mental disorder in mid-life.


Members of the 1946 British birth cohort were assessed for symptoms of depression and anxiety at age 43. Among 157 with mental disorder, those using antidepressants and/or anxiolytics were compared with those not using medications on psychiatric outcomes at age 53.


Use of antidepressants or anxiolytics was associated with a lower prevalence of mental disorder at age 53 (odds ratio (OR)=0.3, 95% CI 0.1–1.0) after adjustment for eight variables in a propensity-for-treatment analysis. Only 24% of those being treated with medications at age 43 were still using them at 53.


Use of antidepressants or anxiolytics during an episode of mental disorder may have long-term beneficial effects on mental health. This may be because of a demonstrated willingness to seek help rather than long-term maintenance therapy.


Corresponding author

Ian Colman, Department of Public Health Sciences, School of Public Health, University of Alberta, 13-130D Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada. Email:


Hide All
1 Judd, LL, Akiskal, HS, Maser, JD, Zeller, PJ, Endicott, J, Coryell, W, Paulus, MP, Kunovac, JL, Leon, AC, Mueller, TI, Rice, JA, Keller, MB. A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry 1998; 55: 694700.
2 Merikangas, KR, Zhang, H, Avenevoli, S, Acharyya, S, Neuenschwander, M, Angst, J. Longitudinal trajectories of depression and anxiety in a prospective community study: the Zurich Cohort Study. Arch Gen Psychiatry 2003; 60: 9931000.
3 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 2003; 361: 653–61.
4 Leon, AC, Solomon, DA, Mueller, TI, Endicott, J, Rice, JP, Maser, JD, Coryell, W, Keller, MB. A 20-year longitudinal observational study of somatic antidepressant treatment effectiveness. Am J Psychiatry 2003; 160: 727–33.
5 Rosenbaum, P, Rubin, DB. The central role of the propensity score in observational studies for causal effects. Biometrika 1983; 70: 4155.
6 Wadsworth, ME, Butterworth, SL, Hardy, RJ, Kuh, DJ, Richards, M, Langenberg, C, Hilder, WS, Connor, M. The life course prospective design: an example of benefits and problems associated with study longevity. Soc Sci Med 2003; 57: 2193–205.
7 Lindelow, M, Hardy, R, Rodgers, B. Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale. J Epidemiol Community Health 1997; 51: 549–57.
8 Paykel, ES, Hayhurst, H, Abbott, R, Wadsworth, M. Stability and change in milder psychiatric disorder over 7 years in a birth cohort. Psychol Med 2001; 31: 1373–84.
9 British Medical Association and Royal Pharmaceutical Society of Great Britain. British 10 National Formulary Number 44. BMJ Group and RPS Publishing Group, 2002.
10 Goldberg, DP, Hillier, VF. A scaled version of the General Health Questionnaire. Psychol Med 1979; 9: 139–45.
11 Ewing, JA. Detecting alcoholism. The CAGE questionnaire. JAMA 1984; 252: 1905–7.
12 Bebbington, PE, Nayani, T. The psychosis screening questionnaire. Int J Methods Psychiatr Res 1995; 5: 1120.
13 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.
14 Seivewright, H, Tyrer, P, Johnson, T. Prediction of outcome in neurotic disorder: a 5-year prospective study. Psychol Med 1998; 28: 1149–57.
15 Mueller, TI, Leon, AC, Keller, MB, Solomon, DA, Endicott, J, Coryell, W, Warshaw, M, Maser, JD. Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. Am J Psychiatry 1999; 156: 1000–6.
16 Colman, I, Croudace, TJ, Wadsworth, ME, Jones, PB. Factors associated with antidepressant, anxiolytic and hypnotic use over 17 years in a national cohort. J Affect Disord 2008 in press.
17 Wing, JK, Cooper, JE, Sartorius, N. The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press, 1974.
18 Wing, JK, Mann, SA, Leff, JP, Nixon, JM. The concept of a ‘case’ in psychiatric population surveys. Psychol Med 1978; 8: 203–17.
19 Paykel, ES, Watters, L, Abbott, R, Wadsworth, M. Do treated psychiatric patients become later community cases? A prospective cohort study. Eur Psychiatry 2006; 21: 315–8.
20 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–9). WHO, 1978.
21 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–10). WHO, 1999.
22 D'Agostino, RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998; 17: 2265–81.
23 Pintor, L, Gasto, C, Navarro, V, Torres, X, Fananas, L. Relapse of major depression after complete and partial remission during a 2-year follow-up. J Affect Disord 2003; 73: 237–44.
24 Ellis, PM, Smith, DA. Treating depression: the beyondblue guidelines for treating depression in primary care. ‘Not so much what you do but that you keep doing it’. Med J Aust 2002; 176 (suppl 40): s7783.
25 Colman, I, Wadsworth, ME, Croudace, TJ, Jones, PB. Three decades of antidepressant, anxiolytic and hypnotic use in a national population birth cohort. Br J Psychiatry 2006; 189: 156–60.
26 Burns, T, Eichenberger, A, Eich, D, Ajdacic-Gross, V, Angst, J, Rossler, W. Which individuals with affective symptoms seek help? Results from the Zurich epidemiological study. Acta Psychiatr Scand 2003; 108: 419–26.
27 Jorm, AF, Christensen, H, Medway, J, Korten, AE, Jacomb, PA, Rodgers, B. Public belief systems about the helpfulness of interventions for depression: associations with history of depression and professional help-seeking. Soc Psychiatry Psychiatr Epidemiol 2000; 35: 211–9.
28 Jorm, AF, Medway, J, Christensen, H, Korten, AE, Jacomb, PA, Rodgers, B. Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Aust N Z J Psychiatry 2000; 34: 619–26.
29 Simon, GE, Goldberg, D, Tiemens, BG, Ustun, TB. Outcomes of recognized and unrecognized depression in an international primary care study. Gen Hosp Psychiatry 1999; 21: 97105.
30 Andrews, G, Issakidis, C, Carter, G. Shortfall in mental health service utilisation. Br J Psychiatry 2001; 179: 417–25.
31 Simon, GE, Fleck, M, Lucas, R, Bushnell, DM. Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry 2004; 161: 1626–34.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Psychiatric outcomes 10 years after treatment with antidepressants or anxiolytics

  • Ian Colman (a1), Tim J. Croudace (a2), Michael E. J. Wadsworth (a3), Diana Kuh (a3) and Peter B. Jones (a2)...
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *