title: [Clinical picture and treatment of subsequent depressive episodes--results of Polish multicenter study].
abstract: OBJECTIVE
  A comparison of the clinical picture and treatment results of the first depressive episode with the second and the third and further depressive recurrence.
  
  
  METHODS
  The study was designed as a one-year, prospective, naturalistic observation of the clinical course of depression. One hundred and sixty-six psychiatrists participated in the study, performed in the years 1999-2000. Data of 179 patients with the first depressive episode, 170 patients with the second episode and 183 patients with third or further episode were included in the analysis.
  
  
  RESULTS
  At the beginning of the observation, the groups of patients did not differ as to age, proportion of gender and intensity of depression, both global and particular symptoms. Patients with the first depressive episode were included into the study after longer duration of symptom occurrence and were more often treated with new generation antidepressants. Comparison of the course of disease revealed higher intensity of depressive symptoms, both global and particular clusters after 6 months and 12 months of treatment, and lower percentage of remission in patients with multiple episodes compared to the first episode group. The type of antidepressant was not significantly related to the efficacy of treatment. Ten patients (2%) had suicidal attempts, one (0.2%) with fatal outcome: in first episode group they were made during initial period of treatment, in multiple episodes--later in the course.
  
  
  CONCLUSIONS
  The results obtained indicate that the course and the treatment outcome of subsequent depressive episodes are less favourable compared to the first depressive episode. Treatment recommendations for depression may be verified based on the results of the study.
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000517:prevention & control* / Q000523:psychology; D017050:Episode of Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011044:Poland; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents
vernacular_title: Obraz i leczenie kolejnych epizodów depresji (wyniki polskiego badania wieloośrodkowego).