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December 23, 1983

Predictors of Relapse in Major Depressive Disorder

Author Affiliations

From the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Drs Keller, Lavori, and Klerman), and the Department of Psychiatry, Washington University, St Louis School of Medicine (Dr Lewis).

JAMA. 1983;250(24):3299-3304. doi:10.1001/jama.1983.03340240025024

Risk of relapse into an affective episode was high in the months immediately after recovery from a major depressive disorder (MDD) in 141 subjects with nonbipolar depression, without a preexisting dysthymic disorder. The probability of relapse then declined steadily during the duration of the follow-up (median follow-up, 62 weeks from recovery). In patients entering the study during their first affective episode, the Research Diagnostic Criteria secondary subtype of MDD and an older age of onset predicted a significantly greater likelihood of relapse. Three or more prior episodes of depression predicted a significantly shorter time to the first and second prospectively observed relapses and, thus, a significantly greater likelihood of subsequent multiple affective episodes.

(JAMA 1983;250:3299-3304)