Achieving gains beyond response.
OBJECTIVE
To review adverse outcomes following response in treatment of depression.


METHODS
Review of published literature with particular emphasis on key papers.


RESULTS
Moderately high rates of relapse and recurrence are found in naturalistic follow-up studies of depressed patients receiving modern treatment. These are reduced but not abolished in controlled trials by continuation and maintenance treatment with antidepressants. Suicide rates in follow-up studies are much elevated compared with the general population. Social function is impaired and remits more slowly than depressive symptoms. A key outcome is the occurrence of incomplete remission with residual symptoms, which is associated with high relapse rates and impaired social function.


CONCLUSIONS
It is important to achieve complete remission in depression. Elimination of residual symptoms is an important target for full treatment of the depressive episode, in order to avoid later adverse outcomes.
Paykel
E S
ES
Department of Psychiatry, University of Cambridge, Cambridge, UK. esp10@cam.ac.uk
D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D015994:Incidence; D012008:Recurrence; D012307:Risk Factors; D012920:Social Behavior Disorders; D013405:Suicide / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D000928:Antidepressive Agents