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The Course, Morbidity, and Costs of Depression

The Course, Morbidity, and Costs of Depression Abstract Eight independently conducted studies that were begun more than a decade ago when the morbidity of major depression, its clinical course, long-term treatment, and impact on children were unclear are reported in this issue of the Archives.1-9 Using different sampling, different levels of severity of depression, different types and lengths of treatment, and patients of different ages, these studies provide an overview and replication of findings on course, morbidity, costs, and treatment of major depression. Cumulatively, the findings clearly show that depression is not ubiquitous, trivial, or transient. If the scope of outcome is broadened to include relapse, recurrence, comorbidity, chronicity, impact on family, absenteeism, and work productivity, it may not be humane, prudent, or economical to limit the identification of depression or shorten its course of treatment. This view may at first seem at variance with current efforts to reduce escalating health care costs or to manage cases. References 1. Evans MD, Hollon SD, DeRubeis RJ, Piasecki JM, Grove WM, Garvey MJ, Tuason VB. Differential relapse after cognitive therapy and pharmacotherapy for depression . Arch Gen Psychiatry . 1992;49:802-808.Crossref 2. Hollon SD, DeRubeis RJ, Evans MD, Wiemer MJ, Garvey MJ, Grove WM, Tuason VB. Cognitive therapy and pharmacotherapy for depression: singly and in combination . Arch Gen Psychiatry . 1992;49:774-781.Crossref 3. Horwath E, Johnson J, Klerman GL, Weissman MM. Depressive symptoms as relative and attributable risk factors for first-onset major depression . Arch Gen Psychiatry . 1992;49:817-823.Crossref 4. Keller MB, Lavori PW, Mueller TI, Endicott J, Coryell W, Hirschfeld RMA, Shea MT. Time to recovery, chronicity, and levels of psychopathology in major depression: a 5-year prospective follow-up of 431 subjects . Arch Gen Psychiatry . 1992;49:809-816.Crossref 5. Kupfer DJ, Frank E, Perel JM, Cornes C, Mallinger AG, Thase ME, McEachran AB, Grochocinski VJ. Five-year outcome for maintenance therapies in recurrent depression . Arch Gen Psychiatry . 1992;49:769-773.Crossref 6. Mintz J, Mintz IL, Arruda MJ, Hwang SS. Treatments of depression and the functional capacity to work . Arch Gen Psychiatry . 1992;49: 761-768.Crossref 7. Shea MT, Elkin I, Imber SD, Sotsky SM, Watkins JT, Collins JF, Pilkonis PA, Beckham E, Glass DR, Dolan RT, Parloff MB. Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program . Arch Gen Psychiatry . 1992;49:782-787.Crossref 8. Warner V, Weissman MM, Fendrich M, Wickramaratne P, Moreau D. The course of major depression in the offspring of depressed parents: incidence recurrence, and recovery . Arch Gen Psychiatry . 1992;49:795-801.Crossref 9. Wells KB, Burnam MA, Rogers W. Course of depression for adult outpatients: results from the medical outcomes study . Arch Gen Psychiatry . 1992;49:788-794.Crossref 10. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 11. Fawcett J. Clinical predictors of suicide in patients with major affective disorders: a controlled prospective study . Am J Psychiatry . 1987; 144:35-40. 12. Frank E, Kupfer DJ, Wagner EF, McEachran AB, Cornes C. Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression: contributing factors . Arch Gen Psychiatry . 1991;48:1053-1059.Crossref 13. Markowitz JS, Weissman MM, Ouellette R, Lish JD, Klerman GL. Quality of life in panic disorder . Arch Gen Psychiatry . 1989;46:984-992.Crossref 14. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware J. The functioning and well-being of depressed patients: results from the medical outcomes study . JAMA . 1989;262:914-919.Crossref 15. Klerman GL, DiMascio A. The broadening scope of research in depressive disorders: an editorial . J Nerv Ment Dis . 1975;160:3-4.Crossref 16. Klerman GL. Depressive disorders: further evidence for increased medical morbidity and impairment of social functioning . Arch Gen Psychiatry . 1989;46:856-858.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

The Course, Morbidity, and Costs of Depression

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1992.01820100075013
Publisher site
See Article on Publisher Site

Abstract

Abstract Eight independently conducted studies that were begun more than a decade ago when the morbidity of major depression, its clinical course, long-term treatment, and impact on children were unclear are reported in this issue of the Archives.1-9 Using different sampling, different levels of severity of depression, different types and lengths of treatment, and patients of different ages, these studies provide an overview and replication of findings on course, morbidity, costs, and treatment of major depression. Cumulatively, the findings clearly show that depression is not ubiquitous, trivial, or transient. If the scope of outcome is broadened to include relapse, recurrence, comorbidity, chronicity, impact on family, absenteeism, and work productivity, it may not be humane, prudent, or economical to limit the identification of depression or shorten its course of treatment. This view may at first seem at variance with current efforts to reduce escalating health care costs or to manage cases. References 1. Evans MD, Hollon SD, DeRubeis RJ, Piasecki JM, Grove WM, Garvey MJ, Tuason VB. Differential relapse after cognitive therapy and pharmacotherapy for depression . Arch Gen Psychiatry . 1992;49:802-808.Crossref 2. Hollon SD, DeRubeis RJ, Evans MD, Wiemer MJ, Garvey MJ, Grove WM, Tuason VB. Cognitive therapy and pharmacotherapy for depression: singly and in combination . Arch Gen Psychiatry . 1992;49:774-781.Crossref 3. Horwath E, Johnson J, Klerman GL, Weissman MM. Depressive symptoms as relative and attributable risk factors for first-onset major depression . Arch Gen Psychiatry . 1992;49:817-823.Crossref 4. Keller MB, Lavori PW, Mueller TI, Endicott J, Coryell W, Hirschfeld RMA, Shea MT. Time to recovery, chronicity, and levels of psychopathology in major depression: a 5-year prospective follow-up of 431 subjects . Arch Gen Psychiatry . 1992;49:809-816.Crossref 5. Kupfer DJ, Frank E, Perel JM, Cornes C, Mallinger AG, Thase ME, McEachran AB, Grochocinski VJ. Five-year outcome for maintenance therapies in recurrent depression . Arch Gen Psychiatry . 1992;49:769-773.Crossref 6. Mintz J, Mintz IL, Arruda MJ, Hwang SS. Treatments of depression and the functional capacity to work . Arch Gen Psychiatry . 1992;49: 761-768.Crossref 7. Shea MT, Elkin I, Imber SD, Sotsky SM, Watkins JT, Collins JF, Pilkonis PA, Beckham E, Glass DR, Dolan RT, Parloff MB. Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program . Arch Gen Psychiatry . 1992;49:782-787.Crossref 8. Warner V, Weissman MM, Fendrich M, Wickramaratne P, Moreau D. The course of major depression in the offspring of depressed parents: incidence recurrence, and recovery . Arch Gen Psychiatry . 1992;49:795-801.Crossref 9. Wells KB, Burnam MA, Rogers W. Course of depression for adult outpatients: results from the medical outcomes study . Arch Gen Psychiatry . 1992;49:788-794.Crossref 10. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 11. Fawcett J. Clinical predictors of suicide in patients with major affective disorders: a controlled prospective study . Am J Psychiatry . 1987; 144:35-40. 12. Frank E, Kupfer DJ, Wagner EF, McEachran AB, Cornes C. Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression: contributing factors . Arch Gen Psychiatry . 1991;48:1053-1059.Crossref 13. Markowitz JS, Weissman MM, Ouellette R, Lish JD, Klerman GL. Quality of life in panic disorder . Arch Gen Psychiatry . 1989;46:984-992.Crossref 14. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware J. The functioning and well-being of depressed patients: results from the medical outcomes study . JAMA . 1989;262:914-919.Crossref 15. Klerman GL, DiMascio A. The broadening scope of research in depressive disorders: an editorial . J Nerv Ment Dis . 1975;160:3-4.Crossref 16. Klerman GL. Depressive disorders: further evidence for increased medical morbidity and impairment of social functioning . Arch Gen Psychiatry . 1989;46:856-858.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Oct 1, 1992

References