Previous studies have indicated a number of factors, such as acute onset, predisposing depressed individuals to early recovery, while lower socio-economic status, dysthymia and personality disorders have been associated with later recovery or chronicity.

Dr Barnett Meyers and colleagues from Cornell University in New York carried out an observational study of factors that predisposed a group of individuals suffering from major depression to early recovery.

In total, 165 subjects took part; all were diagnosed with a major depressive episode according to the Structure Clinical Interview for DSM-IV. Baseline characteristics, including socio-economic status, were assessed at the start of the study.

Patients were re-assessed after three months and results were analyzed for the patient group as a whole and then after stratification according to disease severity.

The researchers found that 30.3 per cent of participants achieved recovery after three months, according to the Longitudinal Interview Follow-up Evaluation, although the majority of patients (55 per cent) had been prescribed inadequate pharmacotherapy. Only 65 per cent of participants were prescribed an antidepressant.

Those with less severe depression, those who received adequate drug treatment, women and married subjects were more likely to recover early compared to the rest of the patient group.

Stratification showed that subjects in the more severe subgroup were more likely to recover early if they were female, while the less severely affected group recovered early if they were married and had less severe personality disorder scores.

Dr Meyers and colleagues conclude that early recovery may be predicted by initial disease severity and adequate drug treatment.

Writing in the Archives of General Psychiatry, they add, “The frequency of recovery is markedly below rates reported in efficacy trials…[which] may result from screening out patients who are unlikely to respond from controlled trials.”

Reference: Meyers et al, Archives of General Psychiatry 2002;59:729-735

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