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The course of depressive illness in general practice
Frédéric Limosin1, Jean-Yves Loze, Myriam Zylberman-Bouhassira
1Department of Psychiatry, Albert Chenevier Hospital, Créteil, France. frederic.limosin@wanadoo.fr
Summary
Recurrent depression increases relapse risk in primary care. Patients with a history of recurrent depression face higher chances of nonresponse or relapse after treatment.
Area of Science:
- Psychiatry
- General Practice
- Clinical Psychology
Background:
- Depression frequently occurs in primary care with a high relapse rate.
- Most studies on depression treatment exclude primary care patients.
Purpose of the Study:
- To examine the treatment course and outcomes for major depressive episode in primary care.
- To identify factors influencing depression treatment success in a general practice setting.
Main Methods:
- Prospective study of outpatients with major depressive episode.
- General practitioners managed treatment choice and duration.
- Outcome assessment included efficacy, safety, and final evaluation at 6 months.
Main Results:
- 64.7% of patients responded to treatment and remained well.
- 24.6% showed no response, and 10.7% relapsed early.
- History of recurrent depression was the sole significant predictor of illness course.
Conclusions:
- Patients with recurrent depression are at increased risk for relapse.
- Recurrent depression is associated with a higher likelihood of nonresponse to treatment.