title: The course of depressive illness in general practice.
abstract: OBJECTIVE
  Depression is reported to be common in primary care settings and to have a high likelihood of relapse during the 4- to 6-month period following initial symptomatic improvement. However, most prospective studies of long-term treatment of depression have been conducted with patients selected for participation in placebo-controlled drug protocols or psychiatric clinics associated with tertiary referral centres.
  
  
  METHODS
  We examined the treatment course and outcome of outpatients with major depressive episode treated in a primary care setting. The general practitioners were free to choose the treatment and its duration. Their only obligation was to assess the therapeutic outcome in terms of efficacy and safety and to perform a final evaluation at the end of the 6-month observation period or, if the patient was treated for a shorter period, at the end of the treatment.
  
  
  RESULTS
  Of the 476 patients involved, 308 (64.7%) responded to treatment and remained well, 117 (24.6%) showed no response, and 51 (10.7%) had an early relapse after initial improvement. Among the studied demographic, clinical, and therapeutic factors, the history of recurrent depression was the only variable with a significant effect size in predicting the course of the illness.
  
  
  CONCLUSIONS
  Patients with recurrent depression were at higher risk of relapse or nonresponse.
authors.affiliation: Department of Psychiatry, Albert Chenevier Hospital, Créteil, France. frederic.limosin@wanadoo.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Limosin
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Loze
authors.forename: Myriam
authors.initials: M
authors.lastname: Zylberman-Bouhassira
authors.forename: Mark E
authors.initials: ME
authors.lastname: Schmidt
authors.forename: Eléna
authors.initials: E
authors.lastname: Perrin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Rouillon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D012008:Recurrence; D012306:Risk; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents