PMID- 17335639
OWN - NLM
STAT- MEDLINE
DCOM- 20071016
LR  - 20071115
IS  - 0033-2917 (Print)
IS  - 0033-2917 (Linking)
VI  - 37
IP  - 8
DP  - 2007 Aug
TI  - Remission and relapse after the first hospital admission in psychotic depression: 
      a 4-year naturalistic follow-up.
PG  - 1173-81
AB  - BACKGROUND: Few studies have examined the course of illness among severely 
      depressed patients ascertained at first hospitalization. Using data from the 
      Suffolk County Mental Health Project (SCMHP), we investigated the times to and 
      predictors of the first full remission and the first relapse during a 4-year 
      period in a first-admission cohort with major depressive disorder (MDD) with 
      psychotic features. METHOD: The cohort included 87 county-wide, first-admission 
      patients with a longitudinal consensus diagnosis of MDD with psychotic features 
      who were systematically followed over a 4-year period. We examined the 
      associations of background, clinical and treatment factors, and time-varying 
      indices of antidepressant (AD) and antipsychotic (AP) medication use to time to 
      remission and relapse using Cox regression. RESULTS: By the 4-year follow-up, 60 
      respondents (69.0%) had achieved a period of full remission (median time of 22 
      weeks among remitters and 54 weeks in the full sample). In the multivariable 
      analysis, longer time to remission was associated with longer latency between 
      initial episode and hospitalization, lower pre-hospital Global Assessment of 
      Functioning (GAF) score, and lack of insurance, but not use of medication. 
      Twenty-six remitters (43.3%) relapsed (median time of 50 weeks among those who 
      relapsed and 192 weeks among all remitters). None of the risk factors or 
      time-varying medication variables was significantly associated with time to 
      relapse. CONCLUSION: Only two-thirds of the sample had at least one full 
      remission by 4 years, and almost half of them subsequently relapsed. Poorer 
      pre-hospital resources predicted remission but not relapse. Medication use over 
      the follow-up was not associated with remission or relapse.
FAU - Naz, Bushra
AU  - Naz B
AD  - Department of Psychiatry, State University of New York at Stony Brook, NY 
      11794-8790, USA.
FAU - Craig, Thomas J
AU  - Craig TJ
FAU - Bromet, Evelyn J
AU  - Bromet EJ
FAU - Finch, Stephen J
AU  - Finch SJ
FAU - Fochtmann, Laura J
AU  - Fochtmann LJ
FAU - Carlson, Gabrielle A
AU  - Carlson GA
LA  - eng
GR  - MH44801/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20070305
PL  - England
TA  - Psychol Med
JT  - Psychological medicine
JID - 1254142
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Affective Disorders, Psychotic/diagnosis/psychology/*rehabilitation
MH  - Antidepressive Agents/therapeutic use
MH  - Antipsychotic Agents/therapeutic use
MH  - Cohort Studies
MH  - Depressive Disorder, Major/diagnosis/psychology/*rehabilitation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - New York
MH  - *Patient Admission
MH  - Personality Assessment
MH  - Recurrence
MH  - Risk Factors
MH  - Statistics as Topic
EDAT- 2007/03/06 09:00
MHDA- 2007/10/17 09:00
CRDT- 2007/03/06 09:00
PHST- 2007/03/06 09:00 [pubmed]
PHST- 2007/10/17 09:00 [medline]
PHST- 2007/03/06 09:00 [entrez]
AID - S0033291707000141 [pii]
AID - 10.1017/S0033291707000141 [doi]
PST - ppublish
SO  - Psychol Med. 2007 Aug;37(8):1173-81. doi: 10.1017/S0033291707000141. Epub 2007 
      Mar 5.