Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-11T17:18:19.487Z Has data issue: false hasContentIssue false
  • English
  • Français

Depression: A Long-Term Illness

Published online by Cambridge University Press:  06 August 2018

Martin B. Keller
Martin B. Keller*
Affiliation:
Butler Hospital, Brown Affiliated Hospitals, 345 Blackstone Boulevard, Providence, RI 02906, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

The realisation that major depression is often both chronic and recurrent has slowly begun to change the way that depression is diagnosed and treated. In particular, the need for continuation and maintenance treatment is an issue that now deserves increased attention, especially with the availability of new classes of antidepressant treatments, which have excellent efficacy and more favourable side-effect profiles. Although the serious consequences of depressive disorders clearly indicate the need for effective and prompt intervention on the part of clinicians, the results of several studies indicate that patients with depression consistently receive no or low levels of antidepressant therapy. It is hoped that, through continued education of health care providers and patients about the consequences of depression, the issue of undertreatment of this serious illness will be resolved.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue S26: Depression: Challenge for the '90s , December 1994 , pp. 9 - 15
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H. S., Rosenthal, T. L., Haykal, R. F., et al (1980) Characterological depressions: clinical and sleep EEG findings separating “subaffective dysthymias” from “character spectrum disorders”. Archives of General Psychiatry, 37, 777–783.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Angst, J. (1988) Clinical course of affective disorders. In Depressive Illness: Prediction of Course and Outcome (eds Helgson, T. & Daly, R. J.). Berlin: Springer.Google Scholar
Angst, J. (1992) How recurrent and predictable is depressive illness? In Long-Term Treatment of Depression (eds Montgomery, S. & Rouillon, F.). New York: John Wiley.Google Scholar
Berglund, M. & Nilsoson, K. (1987) Mortality in severe depression: a prospective study including 103 suicides. Acta Psychiatrica Scandinavica, 76, 372–380.Google Scholar
Frank, E., Kupfer, D. J. & Perel, J. M. (1989) Early recurrence in unipolar depression. Archives of General Psychiatry, 46, 397–400.Google Scholar
Kandel, D. & Davies, M. (1986) Adult sequelae of adolescent depressive symptoms. Archives of General Psychiatry, 43, 255–262.CrossRefGoogle ScholarPubMed
Keller, M. B. (1988) Undertreatment of major depression. Psychopharmacology Bulletin, 24, 75–80.Google Scholar
Keller, M. B. (1990) Depression: underrecognition and undertreatment by psychiatrists and other health care professionals. Archives of Internal Medicine, 150, 946–948.Google Scholar
Keller, M. B., Klerman, G. L., Lavori, P. W., et al (1982) Treatment received by depressed patients. Journal of the American Medical Association, 248, 1848–1855.Google Scholar
Keller, M. B. & Shapiro, R. W. (1982) “Double depression”: superimposition of acute depressive episodes on chronic depressive disorders. American Journal of Psychiatry, 139, 438–442.Google Scholar
Keller, M. B., Lavori, P. W., Lewis, C. E., et al (1983a) Predictors of relapse in major depressive disorder. Journal of the American Medical Association, 250, 3299–3304.Google Scholar
Keller, M. B., Lavori, P. W., Endicott, J., et al (1983b) “Double depression”: two-year follow-up. American Journal of Psychiatry, 140, 689–694.Google ScholarPubMed
Keller, M. B., Klerman, G. L., Lavori, P. W., et al (1984) Long-term outcome of episodes of major depression: clinical and public health significance. Journal of the American Medical Association, 252, 788–792.Google Scholar
Keller, M. B., Lavori, P. W., Rice, J., et al (1986a) The persistent risk of chronicity in recurrent episodes of nonbipolar major depressive disorder: a prospective follow-up. American Journal of Psychiatry, 143, 24–28.Google ScholarPubMed
Keller, M. B., Lavori, P. W., Klerman, G. L., et al (1986b) Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients. Archives of General Psychiatry, 43, 458–466.Google Scholar
Keller, M. B., Lavori, P. W., Mueller, T. I., et al (1992) Time to recovery, chronicity, and levels of psychopathology in major depression: a five-year prospective follow-up of 431 subjects. Archives of General Psychiatry, 49, 809–816.CrossRefGoogle Scholar
Klein, D. N., Taylor, E. B., Harding, K., et al (1988) Double depression and episodic major depression: demographic, clinical, familial, personality, and socioenvironmental characteristics and short-term outcome. American Journal of Psychiatry, 145, 1226–1231.Google Scholar
Kraepelin, E. (1921) Manic Depressive Insanity and Paranoia (ed. Robertson, G. M., trans. Barclay, R. M.). Edinburgh: Livingstone.CrossRefGoogle Scholar
Kupfer, D. J., Frank, E. & Perel, J. M. (1989) The advantage of early treatment intervention in recurrent depression. Archives of General Psychiatry, 46, 771–775.Google Scholar
Lavori, P. W., Keller, M. B., Scheftner, W., et al (1994) Recurrence after recovery in unipolar MDD: an observational follow-up study of clinical predictors and somatic treatment as a mediating factor. International Journal of Methods in Psychiatric Research (in press).Google Scholar
Levitt, A. J., Joffe, R. T. & Macdonald, C. (1991) Life course of depressive illness and characteristics of current episode in patients with double depression. Journal of Nervous and Mental Disease, 179, 678–682.CrossRefGoogle ScholarPubMed
Maj, M., Veltro, F., Pirozzi, R., et al (1992) Pattern of recurrence of illness after recovery from an episode of major depression: a prospective study. American Journal of Psychiatry, 149, 795–800.Google Scholar
Murphy, J., Monson, R., Olivier, D. C., et al (1987) Affective disorders and mortality. Archives of General Psychiatry, 44, 473–480.CrossRefGoogle ScholarPubMed
Perugi, G., Maremmani, I., McNair, D., et al (1988) Differential changes in areas of social adjustment from depressive episodes through recovery. Journal of Affective Disorders, 15, 39–43.CrossRefGoogle ScholarPubMed
Regier, D. A., Boyd, J. H., Burke, J. D. Jr, et al (1988a) One-month prevalence of mental disorders in the United States: based on five epidemiologic catchment area sites. Archives of General Psychiatry, 45, 977–986.CrossRefGoogle ScholarPubMed
Regier, D. A., Hirschfeld, R. M. A., Goodwin, F. K., et al (1988b) The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis. American Journal of Psychiatry, 145, 1351–1357.Google Scholar
Rounsaville, B. J., Sholomskas, D. & Prusoff, B. A. (1980) Chronic mood disorders in depressed outpatients: diagnosis and response to pharmacotherapy. Journal of Affective Disorders, 2, 73–88.Google Scholar
Thase, M. E. (1990) Relapse and recurrence in unipolar major depression: short-term and long-term approaches. Journal of Clinical Psychiatry, 51 (suppl. 6), 51–57.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.