Clinical depression natural history, complications and prognosis

Clinical Depression Microchapters
Home
Patient Information
Major Depressive Disorder (Patient Information)
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Clinical Depression from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Substance/Medication-induced Depressive Disorder
Depressive Disorder due to a Medical Condition
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Psychotherapy
ECT
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Follow-up
Follow-Up
Case Studies
Case #1
Clinical depression natural history, complications and prognosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Clinical depression natural history, complications and prognosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Clinical depression natural history, complications and prognosis
CDC on Clinical depression natural history, complications and prognosis
Clinical depression natural history, complications and prognosis in the news
Blogs on Clinical depression natural history, complications and prognosis
Directions to Hospitals Treating Clinical depression
Risk calculators and risk factors for Clinical depression natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Complications

• People who are depressed are more likely to use alcohol or illegal substances.
• Other complications of depression include:

• Increased risk of physical health problems
• Suicide

Prognosis

Recurrence is more likely if treatment has not resulted in full remission of symptoms.⁴ In fact, current guidelines for antidepressant use recommend 4 to 6 months of continuing treatment after symptom resolution to prevent relapse.

Combined evidence from many randomized controlled trials indicates that continuing antidepressant medications after recovery substantially reduces (halves) the chances of relapse. This preventive effect probably lasts for at least the first 36 months of use.

Anecdotal evidence suggests that chronic disease is accompanied by recurrence after prolonged treatment with antidepressants (tachyphylaxis). Psychiatric texts suggest that physicians respond to recurrence by increasing dosage, complementing the medication with a different class, or changing the medication class entirely. The reason for recurrence in these cases is as poorly understood as the change in brain physiology induced by the medications themselves. Possible reasons may include aging of the brain or worsening of the condition. Most SSRI psychiatric medications were developed for short-term use (a year or less) but are widely prescribed for indefinite periods.