Residual symptoms at remission from depression: impact on long-term outcome.
BACKGROUND
Although residual symptoms after remission from depression are common and predict early relapse, little is known about the impact of residual symptoms on longer-term clinical course of depression or social functioning.


METHODS
Sixty severe recurrent depressives, who remitted from an index episode of depression with residual symptoms or below residual symptomatology, were followed-up at 8-10 years. Subjects underwent detailed longitudinal interviewing on course of depression, treatment and socioecomonic functioning over follow-up.


RESULTS
Long-term follow-up data was obtained on all living subjects and 55 (95%) were interviewed. The residual symptoms group spent more time with depressive symptoms over follow-up but not at full criteria for major depression and showed greater impairment in longitudinal and follow-up social adjustment. No significant differences were found between the two groups in percentage recurring long-term, mean number of recurrences, readmissions, chronic episodes or clinical global outcome criteria.


CONCLUSIONS
Long-term clinical and social outcomes were assessed by a single retrospective longitudinal interview.


CONCLUSIONS
Patients who remit from depression with residual symptomatology continue to have more depressive symptoms and impaired social functioning long-term and may need more aggressive treatment.
Kennedy
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Department of Psychiatry, University of Cambridge, Cambridge, UK. n.kennedy@iop.kcl.ac.uk
Paykel
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D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012074:Remission Induction; D012720:Severity of Illness Index; D012919:Social Behavior; D013997:Time Factors