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Generalisability of existing studies on the naturalistic history of major depression is undermined by overrepresentation of in-patients and tertiary care academic centres, inclusion of patients already on treatment and/or incomplete follow-up.
To report the time to recovery of an inception cohort of unipolar major depressive episodes.
A multi-centre prospective follow-up study of patients with a mood disorder, who had been selected to be representative of the untreated first-visit patients at 23 psychiatric settings from all over Japan.
The median time to recovery of the index episode after treatment commencement was 3 months (95% CI 2.5–3.6): 26% of the cohort reached asymptomatic or minimally symptomatic status by I month, 63% by 3 months, 85% by 12 months and 88% by 24 months.
Our estimate of the episode length was 25–50% shorter than estimates reported in the literature.
The psychosocial correlates of depression during pregnancy were explored.
Pregnant women attending the antenatal clinic of a general hospital (n=1329) received a set of questionnaires including Zung's Self-Rating Depression Score (SDS). SDS high scorers (>49) (the cases: n=179) were compared with low scorers (<38) (the controls; n=343).
The cases were characterised by: first delivery; more nausea, vomiting, and anorexia; more menstrual pains and premenstrual irritability; early paternal loss; lower maternal care and higher paternal overprotection; higher public self-consciousness score; more smoking and use of medication in pregnancy; unwanted pregnancy; negative psychological response to the pregnancy by the woman and husband; poor intimacy by the husband; and having remarried.
Depression in early pregnancy is determined mainly by psychosocial factors.
The literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.
The symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.
Factor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.
These results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.