The Upper Bavarian longitudinal community study 1975-2004. 2. Long-term course and outcome of depression. A controlled study.
OBJECTIVE
The study describes course and outcome over 25 years in depressed and non-depressed men and women from a large community study. Outcome measures covered psychopathology, disability, and impaired functioning.


METHODS
A depressive syndrome (depressed mood and three additional depressive symptoms) was defined and compared to a control condition without depressive symptoms in the seven days preceding baseline assessment. Assessments focused on three time points: baseline survey, 5-year follow-up, and 25-year follow-up. Self-rating scales as well as expert-rating interviews yielded data on a wide range of social and psychopathological risk factors and outcome measures.


RESULTS
Among participants of all three waves (N=838), the baseline prevalence for depressive syndrome was 18.1%. Depressive symptoms manifest at the first wave had substantial impact over the 25-year study. Subjects with a depressive syndrome were predisposed for later adverse mental health outcomes, more disability in social domains and reduced functionality. No long-term increase or decrease of the prevalence of the depressive syndrome was observed.


CONCLUSIONS
There is a persistent and long lasting impact of depressive syndrome, irrespective of diagnostic status, in the general population. Our results underscore the importance of sub-syndromal depressive syndrome when estimating the risk of future mental disorders and functional impairment in the long-term.
Fichter
Manfred M
MM
Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nussbaumstr. 7, 80336 Munich, Germany. MFichter@Schoen-Kliniken.de
Kohlboeck
Gabriele
G
Quadflieg
Norbert
N
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011446:Prospective Studies; D011599:Psychopathology / Q000379:methods*; D019455:Self Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors