title: Prevalence and risk factors for recurrence of depression five years after short term psychodynamic therapy.
abstract: BACKGROUND
  Follow-up research concerning the efficacy of treatment for depression is scarce and varies widely in clinical and methodological terms. Aim was to conduct a five-year follow-up study of recurrence of depression after short supportive Psychodynamic Treatment (PDT) alone or in combination with pharmacotherapy.
  
  
  METHODS
  Patients who had been treated five years previously for major depressive disorder in a randomised control trial comparing short supportive PDT alone or in combination with pharmacotherapy, were traced. Patients who completed treatment were included. Recurrent episodes in the past five years were identified using CIDI. Severity of symptoms after five years was measured with the Hamilton Rating Scale for Depression and sub-scales Depression, Anxiety and Somatisation of the self-report Symptom Checklist 90.
  
  
  RESULTS
  52 (37%) patients of the original sample were localised. 42% had suffered from one or more recurrences during the follow-up period. There was no significant difference between the group who had received psychotherapy and the group who had received combined therapy during the acute phase. Young women and patients with more residual depressive symptoms and less somatic symptoms directly after treatment, were more at risk for recurrence.
  
  
  CONCLUSIONS
  Relatively small study population. Furthermore it was not known if patients received other treatment during the follow-up period.
  
  
  CONCLUSIONS
  The long-term efficacy of PDT (with or without antidepressants) seemed to be comparable with other psychotherapies for depression. But the high recurrence rate urges us to shift the focus of depression treatment to improving long-term outcome and to the prevention of recurrence, in particular for young women and patients with residual symptoms of depression.
authors.affiliation: Arkin Institute for Mental Health, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Koppers
authors.forename: J
authors.initials: J
authors.lastname: Peen
authors.forename: S
authors.initials: S
authors.lastname: Niekerken
authors.forename: R
authors.initials: R
authors.lastname: Van
authors.forename: J
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D003131:Combined Modality Therapy; D003863:Depression; D003866:Depressive Disorder / Q000188:drug therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012307:Risk Factors; D013001:Somatoform Disorders / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents