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58% of people recovering from a major depressive episode are unlikely to relapse after 5 years.(Prognosis)
Q What is the time to recurrence after recovery from an initial episode of major depressive disorder?
METHODS
* Design: Prospective multicentre cohort study.
* Setting: 23 centres across Japan; enrolment December 1992 to December 1995.
* Patients: 95 people with a single or recurrent episode of a major depressive disorder (DSM-IV criteria). People were included if they were in a depressive or manic state at the time of enrolment; > 18 years of age. Exclusions: received antidepressant or antipsychotic medication in the preceding 3 months, and any condition making detailed psychopathological assessment difficult. Mean age of inception cohort was 44.3 years with 59% women.
* Prognostic factors: After recovery from the initial episode, people were considered to have relapsed if they met DSM-IV criteria for major depressive episode, manic episode, or hypomanic episode. In addition, people were considered to have relapsed into a "subthreshold" depressive episode if they did not yet meet the criteria for a major depressive episode, yet had >2 symptoms or had 1-2 symptoms that were graver than mild degree, for one month.
* Outcomes: Time to recurrence after recovery (defined as 2 consecutive months with no more than one or two mild depressive symptoms) from the initial depressive episode.
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