Characteristics and differences in treatment outcome of inpatients with chronic vs. episodic major depressive disorders

Köhler, Stephan; Wiethoff, Katja; Ricken, Roland; Stamm, Thomas; Baghai, Thomas C.; Fisher, Robert B.; Seemüller, Florian; Brieger, Peter; Cordes, Joachim; Malevani, Jaroslav; Laux, Gerd; Hauth, Iris; Möller, Hans‐Jürgen; Zeiler, Joachim; Heinz, Andreas; Bauer, Michael; Adli, Mazda

doi:10.1016/j.jad.2014.10.059

Cited by 24 publications

(20 citation statements)

References 46 publications

(64 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Eight studies (Gilmer et al., ; J. P. Klein, Roniger, Schweiger, Spath, & Brodbeck, ; Köhler et al., ; Lizardi et al., ; Rush et al., ; Szadoczky, Fazekas, Rihmer, & Arato, ; Wiersma et al., , ) found no evidence for an earlier onset in CD. Szadoczky et al.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen of 28 studies compared the relationship/marital status between CD and non‐CD samples (Angst et al., ; Evans et al., ; Garyfallos et al., ; Gilmer et al., ; D. N. Klein et al., , , ; J. P. Klein et al., ; Köhler et al., ; Leader & Klein, ; Ley et al., ; Lizardi et al., ; Riso et al., ; Satyanarayana et al., ; Szadoczky et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…Of 20 studies that compared the educational level between CD and non‐CD patients 16 studies showed a similar level of education for both groups (Angst et al., ; Brockmeyer, Kulessa, Hautzinger, Bents, & Backenstrass, ; Garyfallos et al., ; D. N. Klein et al., , , , ; J. P. Klein et al., ; Köhler et al., ; Leader & Klein, ; Ley et al., ; Lizardi et al., ; Murphy & Byrne, ; Szadoczky et al., ; Wiersma et al., , ). In contrast, four studies found a lower level of education in CD patients versus non‐CD patients with little but significant differences regarding the education years between both groups (Gilmer et al., ; Ildirli, Sair, & Dereboy, ; Satyanarayana et al., ; Sung et al., ).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: There is still uncertainty if and to what extent chronic depression (CD) presents with specific features especially in contrast to the nonchronic course of major depressive disorder (non-CD). This systematic review aims to summarize the existing literature regarding sociodemographic factors, psychopathology, and course of disease in patients with CD in comparison to patients with non-CD. Methods: A structured database search (MEDLINE, PsycINFO, Web of Science, CENTRAL) was performed. All studies comparing CD with non-CD patients were included. Twenty-eight studies, including cohort studies, cross-sectional studies, and observational studies, were identified in which both subgroups were diagnosed according to DSM-IV or DSM-5, respectively. Primary outcome were group comparisons focused on sociodemographic factors, childhood adversity, onset of the disorder, comorbidities, severity and course of the depressive symptoms, and specific psychopathology.Results: Patients with CD had an earlier onset of depressive symptoms, higher rates of psychiatric comorbidities, and a complicated treatment course (e.g., higher rates of suicidality) compared to non-CD. We also found some evidence for specific features in the psychopathology of CD patients (submissive and hostile interpersonal styles) in contrast to non-CD patients. Results were inconsistent with regard to childhood maltreatment. No differences were found regarding the severity of depressive symptoms and most sociodemographic factors. Conclusion:Despite some inconsistencies, the results of this review verified important differences between CD and non-CD. However, future research is needed to characterize especially the specific psychopathology of CD in comparison to non-CD patients to develop more tailored treatment strategies. K E Y W O R D Sassessment/diagnosis, clinical trials, depression, dysthymic disorder, mood disorders 18

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…In terms of inpatient treatment, a lifetime prevalence of 24.1% for hospitalization owing to mental health problems has been reported for PDD patients compared to 12.1% for non-PDD patients [17]. Furthermore, the average duration of past inpatient treatment is longer for PDD cases [53]. Patients with PDD also have higher rates of suicidal attempts and suicidal thoughts and are more likely to have a higher frequency of treatment approaches in general and a longer disorder duration [22].…”

Section: More Severe Pdd Cases In the Health Care Systemmentioning

confidence: 99%

Persistent depressive disorder across the adult lifespan: results from clinical and population-based surveys in Germany

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Although the individual and economic disease burden of depression is particularly high for long-term symptoms, little is known of the lifetime course of chronic depression. Most evidence derives from clinical samples, and the diagnostic distinction between persistent depressive disorder (PDD) and non-chronic major depression (NCMDD) is still debated. Thus, we examined characteristics of PDD among clinical vs. non-clinical cases, and the associated disease burden at a population level. Methods: Data were drawn from the mental health module of the German Health Interview and Examination Survey for Adults (DEGS1-MH, 2009-2012, n = 4483) and a clinical sample of PDD inpatients at Charité -Universitätsmedizin Berlin (2018-2019, n = 45). The DSM-5 definition of PDD was operationalized a priori to the study using interview-based DSM-IV diagnoses of dysthymia and major depression lasting at least 2 years in both surveys. Additional depression characteristics (depression onset, self-classified course, suicidality, comorbid mental disorders, treatment history and current depressive symptoms [Patient Health Questionnaire-9]) were assessed. In the DEGS1-MH, health-related quality of life (Short Form Health Survey-36, SF-36), chronic somatic conditions, number of sick days (past 12 months) or days with limitations in normal daily life activities (past 4 weeks), and health service utilization (past 12 months) were compared for PDD vs. NCMDD. Results: PDD cases from the clinical sample had a significantly earlier depression onset, a higher proportion of selfclassification as persistent course, and treatment resistance than PDD and NCMDD cases in DEGS1-MH. At a population level, PDD cases showed worse outcomes compared with NCMDD cases in terms of somatic comorbidity, SF-36 mental component score, and activity limitations owing to mental health problems, as well as a higher risk for outpatient mental health care contact. Conclusions: The distinction between PDD and NCMDD proposed for DSM-5 seems warranted. Early onset depression, selfclassification as persistent depressive course, and treatment resistance are suggested as markers of more severe and chronic depression courses. At a population level, PDD is associated with remarkably higher individual and economic disease burden than NCMDD, highlighting the need to improve medical recognition of chronic courses and establish specific treatment concepts for chronic depression.

show abstract

“…Die Ansprechbarkeit auf Psychotherapieverfahren (aber auch auf andere Behandlungsformen) ist ausgesprochen heterogen [Cuijpers et al, 2010]; auch auf chronische Depression zugeschnittene Interventionsformen wie CBASP (Cognitive Behavioral Analysis System of Psychotherapy) erreichen nicht alle Patienten in befriedigendem Maße [Arnow et al, 2007;Brakemeier et al, 2015;Monden et al, 2016;Negt et al, 2016]. Eine depressive Restsymptomatik (subsyndromal symptoms) am Ende der Therapie gilt jedoch als Risikofaktor für Rezidive Judd et al, 1997;Köhler et al, 2015;Richards, 2011].…”

unclassified

Entwicklung einer ressourcenorientierten kognitiv-verhaltenstherapeutischen Gruppenbehandlung für chronisch depressive Patienten: Eine Pilotstudie

Troesken

Renneberg

2019

Verhaltenstherapie

View full text Add to dashboard Cite

Hintergrund: Chronisch depressive Patienten profitieren im Durchschnitt weniger von psychotherapeutischen Verfahren als Patienten mit einer akuten oder rezidivierenden depressiven Störung. Eine Augmentierung der Einzeltherapie durch eine ressourcenorientierte Gruppentherapie könnte zu einer Verbesserung der Wirksamkeit führen. Stichprobe: 16 chronisch depressive Patienten nahmen zusätzlich zu einer Einzeltherapie an einer Gruppentherapie mit 12 Sitzungen teil. Methode: Die Schwere der depressiven Symptomatik (Becks Depressions-Inventar(BDI)-II) wurde zu 4 Messzeitpunkten (zu Beginn der Therapie, vor der Gruppentherapie, nach der Gruppentherapie und nach der Gesamttherapie) erfasst. Neben der varianzanalytischen Auswertung wurde der Reliable Change Index berechnet. Vor und nach der Gruppe wurden darüber hinaus die Ressourcenrealisierung Wohlbefinden (RES-WB) und das Inkongruenzniveau (INK-K) erfasst. Individuelle Zielerreichungen und die Bewertung der Gruppentherapie durch die Patienten werden berichtet. Ergebnisse: Die Depressivität nahm über den gesamten Therapiezeitraum signifikant ab (_pη = 0,853, p < 0,001; Einzeltherapie vor der Gruppe: _pη = 0,25, p = 0,051; Gruppentherapie + Einzeltherapie: _pη = 0,35, p < 0,05; Einzeltherapie nach der Gruppentherapie: _pη = 0,79, p < 0,001). Sieben Patienten waren reliabel verbessert, 6 Patienten remittiert. Auch andere direkte und indirekte Erfolgsmaße zeigten vielversprechende Ergebnisse. Einschränkungen: Berichtet werden erste Ergebnisse einer Pilotstudie im naturalistischen Setting ohne randomisierte Zuweisung, es gab keine Kontrollgruppe. Schlussfolgerungen: Der Einsatz aktiver, ressourcenorientierter Methoden in einer kognitiv-behavioralen Gruppentherapie der Depression zeigte vielversprechende Ergebnisse. In einem kontrollierten Design mit einer größeren Stichprobe sollen differenzielle Effekte untersucht werden.

show abstract

Characteristics and differences in treatment outcome of inpatients with chronic vs. episodic major depressive disorders

Cited by 24 publications

References 46 publications

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

Persistent depressive disorder across the adult lifespan: results from clinical and population-based surveys in Germany

Entwicklung einer ressourcenorientierten kognitiv-verhaltenstherapeutischen Gruppenbehandlung für chronisch depressive Patienten: Eine Pilotstudie

Contact Info

Product

Resources

About