Practice guidelines endorse maintenance antidepressant treatment for recurrent major depressive disorder. In the Vantaa Depression Study, we followed 218 psychiatric patients with major depressive disorder for up to 5 years with a life-chart. Of these patients, 86 (39.4%) had more than three lifetime episodes and an indication for maintenance pharmacotherapy. However, of these, only 57% received treatment and only for 16% of the time indicated. Good adherence to pharmacotherapy in the acute phase independently predicted maintenance treatment. The tertiary preventive impact of maintenance treatment may remain limited, as many patients with major depressive disorder either do not receive it, or receive it for too short a period.

Post-traumatic stress disorder (PTSD) can reduce performance. The association between PTSD and other psychopathologies among hospital doctors was examined using self-report questionnaires during a wave of suicide bombing in Jerusalem. Thirty-three doctors with PTSD symptoms and 155 without were compared on coping, burnout and acceptance of treatment. Doctors with PTSD symptoms demonstrated significantly more anxiety, depression, negative coping strategies and burnout. Hospital doctors who develop PTSD symptoms suffer greater burnout and manifest negative coping strategies but are reluctant to receive treatment.