Definitions of recovery and outcomes of major depression: results from a 10-year follow-up.
OBJECTIVE
Consensus operational definitions for symptomatic remission and recovery of a major depressive episode have been proposed but only irregularly followed.


METHODS
We examined the predictive validity of different definitions of recovery in a multi-center 10-year follow-up study of an inception cohort of untreated unipolar major depressive episodes (n = 95). Time to recovery and time to recurrence after recovery were estimated by Kaplan-Meier survival analyses for alternative definitions requiring 2, 4, 6 or 12 months of remission to declare recovery.


RESULTS
The median time to recovery was 3.0, 4.0, 4.0 and 12.0 months respectively. The index episode lasted longer than 24 months in 9.4%, 9.2%, 12.6% and 24.5%. The median time to subthreshold recurrence was 16.0, 32.0, 42.0 and 74.0 months.


CONCLUSIONS
Either 4- or 6-month duration of remission defined a change point before which the episode was continuous and after which the recurrence was reasonably unlikely.
Furukawa
T A
TA
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. furukawa@med.nagoya-cu.ac.jp
Fujita
A
A
Harai
H
H
Yoshimura
R
R
Kitamura
T
T
Takahashi
K
K
D000328:Adult; D015331:Cohort Studies; D003289:Convalescence; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome