November 1997

Recovery From Major DepressionA 10-Year Prospective Follow-up Across Multiple Episodes

Author Affiliations

From the Department of Psychiatry and Human Behavior, Brown University, Providence, RI (Drs Solomon, Keller, Mueller, and Shea and Ms Warshaw); Department of Psychiatry, Cornell University, New York, NY (Dr Leon); National Institute of Mental Health, Washington, DC (Dr Maser); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Dr Coryell); and Department of Research and Training, New York State Psychiatric Institute, New York, NY (Dr Endicott). The names of the investigators participating in the National Institute of Mental Health—Collaborative Program on the Psychobiology of Depression (Collaborative Depression Study) are listed at the end of this article.

Arch Gen Psychiatry. 1997;54(11):1001-1006. doi:10.1001/archpsyc.1997.01830230033005

Background:  Major depressive disorder is often marked by repeated episodes of depression. We describe recovery from major depession across multiple mood episodes in patients with unipolar major depression at intake and examine the association of sociodemographic and clinical variables with duration of illness.

Methods:  A cohort of 258 subjects treated for unipolar major depressive disorder was followed up prospectively for 10 years as part of the Collaborative Depression Study, a multicenter naturalistic study of the mood disorders. Diagnoses were made according to the Research Diagnostic Criteria, and the course of illness was assessed with the Longitudinal Interval Follow-up Evaluation. Survival analyses were used to calculate the duration of illness for the first 5 recurrent mood episodes after recovery from the index episode.

Results:  Diagnosis remained unipolar major depressive disorder for 235 subjects (91%). The median duration of illness was 22 weeks for the first recurrent mood episode, 20 weeks for the second, 21 weeks for the third, and 19 weeks for the fourth and fifth recurrent mood episodes; the 95% confidence intervals were highly consistent. From one episode to the next, the proportion of subjects who recovered by any one time point was similar. For subjects with 2 or more recoveries, the consistency of duration of illness from one recovery to the next was low to moderate. None of the sociodemographic or clinical variables consistently predicted duration of illness.

Conclusion:  In this sample of patients treated at tertiary care centers for major depressive disorder, the duration of recurrent mood episodes was relatively uniform and averaged approximately 20 weeks.