Impact of clinical variables on illness time course in mood disorders

The aim of this study is to investigate possible clinical predictors of the long-term outcome of mood disorders. We undertook a retrospective assessme nt of 426 inpatients affected by major depressive disorder (n = 182) and bi polar disorder (n = 244), with at least two episodes of illness alternating with complete recovery; subjects were affected for an average of 14.43 +/- 11.34 years and presented an average of 4.4 +/- 2.1 episodes. Random regre ssion model analysis (http://ww.uic.eu/hedeker/mix.html) was used to invest igate the longitudinal time course of the illness. A progressive cycle shor tening was observed, whereby the more episodes a subject experienced, the s horter the interval was between episodes, up to a plateau frequency of one episode/year on average. Bipolar diagnosis was the strongest predictive fac tor toward high frequency of episodes; a manic onset among bipolars was ass ociated with an even worse outcome. Gender, education level, family history , duration of the first interval, severity of the first episode, lifetime m ean severity and lifetime mean treatment level were not associated with out come in terms of episode frequency. Our results suggest that recurrent affe ctive disorders recruited in a clinical setting have a marked deteriorating mean time course. (C) 2000 Elsevier Science Ireland Ltd. All rights reserv ed.