title: Fast versus slow onset of depressive episodes: a clinical criterion for subtyping patients with major depression.
abstract: OBJECTIVE
  The speed of onset of depressive episodes is a clinical aspect of affective disorders that has not been sufficiently investigated. Thus, we aimed to explore whether patients with fast onset of the full-blown depressive symptomatology (≤7 days) differ from those with slow onset (>7 days) with regard to demographic and clinical aspects.
  
  
  METHODS
  Data were obtained within an observational study conducted in outpatients with major depression who were treated with duloxetine (30-120 mg/day). Onset of depression (without any preceding critical life event) was fast in 416 (less than one week) and slower in 2220 patients.
  
  
  RESULTS
  Compared to patients with slow onset, those with fast onset of depression had more suicide attempts in the previous 12 months (2.7% versus 1.3%, P=0.046) and less somatic comorbidity (61.7% versus 74.1%, P<0.0001). In addition, they were slightly younger at onset of depression (mean±SD 40.2±14.6 versus 42.8±14.2 years, P<0.001) and used analgesics at baseline significantly less frequently (22.8% versus 33.4%, P<0.0001).
  
  
  CONCLUSIONS
  The speed of onset of depression has to be regarded as a relevant clinical characteristic in patients with unipolar depression.
authors.affiliation: Department of Psychiatry, University of Leipzig, Semmelweisstr. 10, 04103 Leipzig, Germany. Ulrich.Hegerl@medizin.uni-leipzig.de
authors.forename: U
authors.initials: U
authors.lastname: Hegerl
authors.forename: R
authors.initials: R
authors.lastname: Mergl
authors.forename: D
authors.initials: D
authors.lastname: Quail
authors.forename: E
authors.initials: E
authors.lastname: Schneider
authors.forename: M
authors.initials: M
authors.lastname: Strauß
authors.forename: H-P
authors.initials: HP
authors.lastname: Hundemer
authors.forename: M
authors.initials: M
authors.lastname: Linden
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000145:classification* / Q000188:drug therapy / Q000523:psychology; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted; D013876:Thiophenes / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride