Treated versus Untreated Major Depressive Episodes

Abstract

It is a plausible hypothesis that among treated cases of major depressive episodes (MDE) in the community, females will be overrepresented, episodes will be more severe, the course of the disorder will be more frequently chronic and the consequences in the depression more serious. This hypothesis was tested on the subjects of the Zürich cohort study, an enriched population sample (n = 591), which was examined 5 times between the ages of 20 and 35. We found a longitudinal prevalence rate for MDE of 20.2% (13.5% for males and 26.7% for females). 173 subjects met DSM-IV criteria for MDE and of those 66 (38%) had been treated for depression in the preceding 12-month period. 82% of the treated cases were females; in untreated subjects the sex ratio F/M was 1.2:1. Treated cases were found to be more severely depressed, they spent more days in depression over 1 year, experienced greater suffering and suffered more work and social impairment. However, in terms of family history of depression and age of onset, treated and untreated cases did not differ. Surprisingly, there was a trend to a more favorable course among treated subjects than in the untreated group. Compared with controls, untreated subjects demonstrated normal coping skills. The treated cases differed from both untreated subjects and controls in their aggression and neuroticism scores.

The Influence of Psychopathology, Personality, and Marital Interaction on the Short-Term Course of Major Depression

“…However, if the severity of depression as measured by HAM-D is excluded, the MMPI effects become weaker but remain significant and to our surprise MPI neuroticism becomes predictive of unfavorable 1-year course. This result fits in nicely with those of Angst et al [31] and Marneros et al [32] who also found that the pre-index course and personality are the main factors influencing short-term course.…”

Comparison of Treated and Untreated Major Depressive Disorder in a Nationwide Sample of Korean Adults

“…The lifetime treatment rate of individuals with a lifetime diagnosis of MDD (32.3%) were lower than the results of most community-based surveys in Western countries using a time span of 12 months except the only one study (Kessler et al 1999); for example rates of 57.3% were reported in American population (Kessler et al 2003), 48.0% in Canadian population (Wang 2004), 45.3% in the Netherlands (Spijker et al 2001), and 38.0% in Switzerland (Angst 1998). This rate was also much lower than the (Ma et al 2009).…”

“…Some of the discrepancies across studies may be related to differences in the diagnostic criteria of MDD, the study period or the definition of treatment. Several previous studies used DSM-III-R criteria (Angst 1998;Galbaud du Fort et al 1999;Kessler et al 1999;Spijker et al 2001), whereas others (Kessler et al 2003;Wang 2004), including ours used DSM-IV criteria to diagnose MDD. Moreover, the recent growth in the medical service market may have affected the differences in treatment rates between older and more recent studies.…”

“…Previous community-based surveys have found that mental health services are underused by individuals with MDD (Angst 1998;Kessler et al 2003;Spijker et al 2001;Wang 2004). Rates of treatment-seeking behavior are even lower in Asian countries.…”

“…Epidemiological studies suggest that older age (Coryell et al 1995;Crabb and Hunsley 2006), higher education (Gadalla 2008;Wang 2004) and social support (Gadalla 2008), recurrent or longer episodes (Angst 1998;Coryell et al 1995;Kessler et al 2003;Wang et al 2004), more severe depression (Angst 1998;Kessler et al 2003), greater role impairment (Angst 1998;Coryell et al 1995;Kessler et al 2003), high daily stress levels (Wang 2004), suicidal thoughts (Wang 2004), number of psychiatric comorbidity (Kessler et al 2003), and the presence of medical illness (Crabb and Hunsley 2006) are associated with treatment seeking in individuals with MDD.…”