Depression: factors related to 10-year prognosis

The 10 years' course of a series of 83 moderately severe depressions is presented, as well as factors governing the clinical and work prognosis. Depression was the fundamental disturbance in 75 cases during the index period. The depression was endogenous in 67 cases, reactive in eight, and neurotic in six cases. In the follow-up the drop-out from personal examination was 6.4%. Twenty per cent of the patients had been (almost) entirely free from symptoms of depression during the period of observation, 5% had been continuously depressive. There were no suicides. Twenty-seven patients felt some decrease in working capacity during the depressions, but only seven were unable to continue their previous work and three had changed work to prevent relapses. Fourteen of the patients had been sick-listed for more than 1 year of the observation period. Favourable factors for long-term course were: high intellectual capacity (for work prognosis, W), afraid of hurting others (W), white collar work (W), slight depression of mood during index period (for clinical course, C), favourable immediate outcome after index period (W). Unfavourable factors for long-term course were: low intellectual capacity (W), hysteroid personality (C), syntonic personality (W), asthenic personality, sensitivity to praise (C), tendency to feel under observation (W), and some symptoms during the index period: tendency to seclusion (C), ideas of reference (C), dryness of mouth (C), difficulty in falling asleep (C), dreamlike feeling (C), supplicating attitude (C). The implications of the results for nosology, care, and prevention of depressive states are discussed.