title: Duration of untreated depression influences clinical outcomes and disability.
abstract: BACKGROUND
  The duration of untreated depression (DUD) might have a substantial impact on the clinical outcomes; however, there are important knowledge gaps including the effects on disability and potential differences between first-episode and recurrent episodes of depression.
  
  
  METHODS
  We recruited 121 outpatients with first episode and recurrent major depression, and conducted prospective clinical assessments over six months. Clinical outcomes included response to antidepressant therapy, remission and changes in disability.
  
  
  RESULTS
  Patients with a DUD of six months or shorter were more frequently young, unemployed and had higher levels of physical illnesses than those with a longer DUD (all p<0.05). A shorter DUD was associated with significantly higher odds of response at 12 weeks (adjusted odds ratio 2.8; 95% CI: 1.2-6.8) and remission at 24 weeks (4.1; 95% CI: 1.6-10.5) after adjusting for relevant confounders. Changes in disability ratings were analyzed with growth curve analysis and showed steeper declines among those with a shorter DUD. The associations of DUD on clinical outcomes were evident both in patients with first-episode and recurrent depression.
  
  
  CONCLUSIONS
  Naturalistic design. Self-rated assessment of disability. Findings from subgroup analyses should be replicated in larger sample size.
  
  
  CONCLUSIONS
  A shorter duration of untreated depression is associated with more favorable outcomes for major depression, including depression-related disability. This association seems to work both at the first and recurrent episodes, which might have direct implications for both primary and secondary prevention.
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy. Electronic address: lu.ghio@libero.it.
authors: Lucio
authors: L
authors: Ghio
authors: Department of Mental Health, ASL3, Genoa, Italy.
authors: Simona
authors: S
authors: Gotelli
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Alice
authors: A
authors: Cervetti
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Matteo
authors: M
authors: Respino
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Werner
authors: W
authors: Natta
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Maurizio
authors: M
authors: Marcenaro
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Gianluca
authors: G
authors: Serafini
authors: Department of Mental Health, ASL3, Genoa, Italy.
authors: Marco
authors: M
authors: Vaggi
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Mario
authors: M
authors: Amore
authors: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Italy.
authors: Martino
authors: M
authors: Belvederi Murri
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant; Depression; Disability; Early intervention; Prevention; Untreated illness