Hopelessness and Low Social and Occupational Functioning are Associated with Non-Recovery from Depression—Results of a 6-Year Follow-Up Study

H. Viinamäki, H. Koivumaa-Honkanen, K. Honkalampi, K. Haatainen, T. Tolmunen, R. Antikainen, J. Hintikka
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Abstract

Objective The aim of this study was to explore variables associated with poor recovery from depression. Method A sample of depressive patients (n = 121) referred to treatment was followed prospectively for 6 years. Clinical evaluations were done at baseline and at 6 month, 1, 2 and 6 years study visits. A diagnosis of major depression based on SCID interview at 6 year and high BDI score along follow-up indicated poor recovery. A diagnosis of full remission at 6 year and low BDI score during follow-up indicated good recovery. Results Chronic depression was found in 15% of patients. A repeated measures analysis of variance of HDRS-, SCL-90, hopelessness (HS) and Social and Occupational Functioning Assessment Scale (SOFAS) scores showed that those with poor recovery had recovered poorly also according these scales during the whole follow-up. Treatment factors did not associate with recovery. Logistic regression analyses revealed an independent association between poor recovery at 6 year and both high HS- and low SOFAS scores at 12 months, 24 months and 6 year assessments. Conclusions Assessment of hopelessness and social and occupational functioning help to early identify high-risk patients who would be in need for more individually tailored treatments.
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绝望、低社会和职业功能与抑郁症无法康复相关——一项6年随访研究的结果
目的探讨抑郁症患者康复不良的相关因素。方法对121例抑郁症患者进行前瞻性随访,随访6年。临床评估在基线和6个月、1年、2年和6年的研究访问中进行。根据6年的SCID访谈和随访时的高BDI评分诊断为重度抑郁症,表明恢复不良。6年诊断为完全缓解,随访期间BDI评分较低,表明恢复良好。结果慢性抑郁发生率为15%。对HDRS-、SCL-90、无望感(HS)和社会与职业功能评估量表(SOFAS)得分的方差进行重复测量分析发现,在整个随访过程中,恢复较差的患者在这些量表上的恢复也较差。治疗因素与康复无关。Logistic回归分析显示,6年恢复差与12个月、24个月和6年评估时HS-和SOFAS评分高和低之间存在独立关联。结论:对绝望感、社会和职业功能的评估有助于早期识别需要更个性化治疗的高危患者。
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