Long-term prognosis of depression in primary care

This article uses longitudinal data from a primary care sample to examine l ong-term prognosis of depression. A sample of 225 patients initiating antid epressant treatment in primary care completed assessments of clinical outco me (Hamilton Depression Rating Scale and the mood module of the Structured Clinical Interview for DSM-IIIR) 1, 3, 6, 9, 12, 18 and 24 months after ini tiating treatment. The proportion of patients continuing to meet criteria f or major depression fell rapidly to approximately 10% and remained at appro ximately that level throughout follow-up. The proportion meeting criteria f or remission (Hamilton Depression score of 7 or less) rose gradually to app roximately 45%. long-term prognosis (i.e. probability of remission at 6 mon ths and beyond) was strongly related to remission status at 3 months (odds ratio 3.65; 95% confidence interval, 2.81-4.76) and only modestly related t o various clinical characteristics assessed at baseline (e.g, prior history of recurrent depression, medical comorbidity, comorbid anxiety symptoms). The findings indicate that potentially modifiable risk factors influence th e long-term prognosis of depression. This suggests that more systematic and effective depression treatment programmes might have an important effect o n long-term course and reduce the overall burden of chronic and recurrent d epression.