FUTURE IMPERFECT - THE LONG-TERM OUTCOME OF DEPRESSION

During 1976, 80 patients with a primary depressive illness were select ed from a consecutive series of referrals to the Royal Edinburgh Hospi tal for a short-term follow-up study. This paper concerns the 12-year longitudinal assessment of the survivors. During the follow-up, mortal ity risk for the sample was almost doubled. Of the series, 35% had exp erienced a recurrence within 2 years of the initial interview, and jus t over 60%-within the entire study time of 12 years. The risk of recur rence was enhanced for those aged over 45 years at index, for those wi th a history of depressive disorder and for those who had not engaged in parasuicidal behaviour during the index episode. The observed effec t of previous episodes was largely accounted for by age. The chance of recurrence was not affected by whether the treatment of the index epi sode included ECT, or by whether diagnosis was 'endogenous' or 'neurot ic'. Application of the Lee-Murray outcome criteria showed that about one-third of the Edinburgh series experienced a very poor outcome. Res ults are presented concerning the prediction of long-term outcome as r epresented by the Depression Outcome Scale (DOS), a measure specially constructed for this study.