Clinical Medicine Insights: Psychiatry

Heimo Viinamäki, Heli Koivumaa-Honkanen¹, Kirsi Honkalampi, Kaisa Haatainen, Tommi Tolmunen, Risto Antikainen, Jukka Hintikka

Department of Psychiatry, Kuopio University Hospital and University of Kuopio, Finland. ¹Institute of Clinical Medicine, University of Oulu and Lapland Hospital District, Muurola Hospital.

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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