A comparison of the three year course between chronic depression and depression with multiple vs. few prior episodes

Humer, Elke; Kocsis-Bogár, Krisztina; Berger, Thomas; Schröder, Johanna; Späth, Christina; Meyer, Björn; Moritz, Steffen; Lutz, Wolfgang; Probst, Thomas; Klein, Jan Philipp

doi:10.1016/j.psychres.2020.113235

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…Möglicherweise ist die Grenze zwischen chronischer und episodischer Depression dabei auch fließend: In einer 3-jährigen Nachbeobachtung hatten Betroffene mit einer episodischen Depression und mindestens 5 depressiven Episoden einen ähnlichen Verlauf wie Betroffene mit einer chronischen Depression. Beide Gruppen unterschieden sich in Hinsicht auf die Wahrscheinlichkeit, eine Remission zu erreichen, im Langzeitverlauf von Patient*innen mit einer episodischen Depression und weniger als 5 depressiven Episoden [7].…”

Section: Definitionunclassified

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CBASP – eine evidenzbasierte und praxisorientierte Einführung

2022

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Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) ist die bislang einzige störungsspezifische Psychotherapie, welche sich mit den psychopathologischen Besonderheiten von Patient*innen mit chronischen Depressionen befasst. Dieser Beitrag will die Ergebnisse der bisher erfolgten Forschung zu CBASP übersichtlich und für die praktische Anwendung komprimiert zusammenfassen und die Anwendung des CBASP-Verfahrens anhand eines Beispiels veranschaulichen.

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Section: Definitionunclassified

“…6 In dieser Studie wurden auch Patient*innen mit nicht-chronischer Depression eingeschlossen. 7 In dieser Studie wurde nur die Response-und nicht die Remissionsrate angegeben. Response war definiert als eine 50% Verbesserung der depressiven Symptomatik.…”

Section: Indikation Auf Grundlage Der Diagnoseunclassified

CBASP – eine evidenzbasierte und praxisorientierte Einführung

2022

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“…Previous studies have shown associations between inflammation and subsequent persistent depressive symptoms. Investigating such severity and burden is important since multiple depressive episodes have been shown to associate with a more severe depressive phenotype and treatment resistance (7, 8) and persistent PEs are associated with developing severe mental health problems(9). Here, we extend these studies by investigating whether early-life inflammation associates with the burden of depressive episodes and PEs, measured during a longer follow-up period up to 28 years of age.…”

Section: Introductionmentioning

confidence: 99%

Early-life inflammatory markers and subsequent episodes of depression and psychotic experiences in the ALSPAC birth cohort

Edmondson-Stait

Shen

Adams

et al. 2022

Preprint

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Background Inflammation is implicated in depression and psychosis, including association of childhood inflammatory markers on the subsequent risk of developing symptoms. However, it is unknown whether early-life inflammatory markers are associated with the number of depressive and psychotic symptoms from childhood to adulthood. Methods Using the prospective Avon Longitudinal Study of Children and Parents birth cohort (N=up-to 6,401), we have examined longitudinal associations of early-life inflammation [exposures: interleukin-6 (IL-6), C-reactive protein (CRP) levels at age 9y; IL-6 and CRP DNA-methylation (DNAm) scores at birth and age 7y; and IL-6 and CRP polygenic risk scores (PRSs)] with the number of depressive episodes and psychotic experiences (PEs) between ages 10-28 years. Psychiatric outcomes were assessed using the Short Mood and Feelings Questionnaire and Psychotic Like Symptoms Questionnaires, respectively. Exposure-outcome associations were tested using negative binomial models, which were adjusted for metabolic and sociodemographic factors. Results Serum IL-6 levels at age 9y were associated with the total number of depressive episodes between 10-28y (n=4,262; β=0.086; 95%CI:0.036-0.137; pFDR=0.009). CRP DNAm score at birth was associated with total number of PEs, size but this association did not survive correction for multiple testing (n=822; β=0.204; 95%CI:0.024-0.388; p uncorrected=0.027; pFDR=0.252). Other immune measures were not associated with depression or PEs. Conclusions Early-life inflammatory markers are associated with the burden of depressive episodes and of PEs subsequently from childhood to adulthood. These findings support a potential role of early-life inflammation in the aetiology of depression and psychosis and highlight inflammation as a potential target for treatment and prevention.

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“…Thus, it could be argued that a valid categorization of chronic versus nonchronic depression should be between patients experiencing just one or few episodes of MDD and patients that experience either repeated recurrence or persistence of depression. Thus, many studies on chronicity of depression include recurrent MDD as well as PPD but vary on whether two or more (DeRubeis et al, 2020; Hollon et al, 2014; Ma & Teasdale, 2004), three or more (Barnhofer et al, 2009), or five or more (Bockting et al, 2005; Humer et al, 2020) episodes constitute a pattern of chronicity. In sum, these findings indicate that PDD and rMDD should be investigated together in studies exploring chronic forms of depression, as is the case in the present study.…”

Section: Introductionmentioning

confidence: 99%

Comparing outcomes in chronic depression following inpatient psychotherapy for patients continuing versus discontinuing antidepressant medication

Høstmælingen

Ulvenes

Nissen‐Lie

et al. 2021

Clin Psychology and Psychoth

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Research indicates that combination of psychotherapy and antidepressant medication (ADM) provides cumulative effects and thus outperforms monotherapy in treating chronic depression. In this quasi‐experimental study, we explored symptom change for patients with chronic depression treated with ADM when presenting for a 12‐week psychotherapeutic inpatient treatment programme. We compared outcomes through treatment and follow‐up of patients who continued medication with those who discontinued. We also tested possible moderator effects of initial depression severity on change between the groups. Based on prior research, we hypothesized that combination treatment would yield better results (i.e., more reduction in depression). Patients (N = 112) were referred from general practitioners or local secondary health care. Outcome was measured by Beck Depression Inventory‐II (BDI‐II), and comparisons were carried out using multilevel modelling. Although 35 patients discontinued ADM during treatment, 77 continued. Both continuers and discontinuers had a significant treatment effect that was maintained at 1‐year follow‐up. There was no difference in outcome between continuers and discontinuers of ADM. Patients with severe depression had significantly more symptom improvement than patients with moderate depression, but depression severity did not affect outcomes across continuers and discontinuers of ADM differently. The results could indicate that patients had developed resistance and/or tolerance to the prophylactic effects of medication and that ADM did not contribute to the reduction of depressive symptoms. The findings may also indicate that psychotherapy alone in some instances can be a viable alternative to continued combined treatment. Clinicians should carefully assess benefits of patients' ongoing use of antidepressant medication when entering psychotherapy.

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A comparison of the three year course between chronic depression and depression with multiple vs. few prior episodes

Cited by 9 publications

References 26 publications

CBASP – eine evidenzbasierte und praxisorientierte Einführung

CBASP – eine evidenzbasierte und praxisorientierte Einführung

Early-life inflammatory markers and subsequent episodes of depression and psychotic experiences in the ALSPAC birth cohort

Comparing outcomes in chronic depression following inpatient psychotherapy for patients continuing versus discontinuing antidepressant medication

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