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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2003 Jul;74(7):893–896. doi: 10.1136/jnnp.74.7.893

The outcome of depressive disorders in neurology patients: a prospective cohort study

A Carson 1, K Postma 1, J Stone 1, C Warlow 1, M Sharpe 1
PMCID: PMC1738555  PMID: 12810774

Abstract

Background: In a previous prospective study of 300 consecutive new attenders at neurology outpatient clinics, depressive disorders were diagnosed in 119 patients (40%) and major depressive disorder in 77 (26%).

Objective: To describe the eight month outcome of depression in this cohort.

Methods: Patients were reinterviewed eight months after their baseline assessment. Mental state was examined using the primary care evaluation of mental disorders (PRIME-MD) interview and the hospital anxiety and depression (HAD) self rating scale. Health status was measured using the medical outcome study 36 item short form scale (SF-36).

Results: Of the original cohort of 300, 226 (75%) participated in the follow up. Among them, 88 had a depressive disorder at baseline and 69 (78%) of those were still depressed at follow up; 54 had major depression at baseline and 46 (85%) of those still had a major depressive disorder at follow up. Among the 138 patients who had no depression at baseline, 20 new major depressive disorders had developed by the time of follow up. Resolution of major depressive disorders was associated with an improvement in health status.

Conclusions: Most depressive disorders detected in neurology outpatients persist at an eight month follow up, and a substantial number of new cases arise. Resolution of depressive disorders, particularly major depressive disorder, is associated with an improvement in health status.

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Selected References

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  1. Aström M., Adolfsson R., Asplund K. Major depression in stroke patients. A 3-year longitudinal study. Stroke. 1993 Jul;24(7):976–982. doi: 10.1161/01.str.24.7.976. [DOI] [PubMed] [Google Scholar]
  2. Brown R. G., MacCarthy B., Gotham A. M., Der G. J., Marsden C. D. Depression and disability in Parkinson's disease: a follow-up of 132 cases. Psychol Med. 1988 Feb;18(1):49–55. doi: 10.1017/s0033291700001872. [DOI] [PubMed] [Google Scholar]
  3. Carson A. J., Ringbauer B., MacKenzie L., Warlow C., Sharpe M. Neurological disease, emotional disorder, and disability: they are related: a study of 300 consecutive new referrals to a neurology outpatient department. J Neurol Neurosurg Psychiatry. 2000 Feb;68(2):202–206. doi: 10.1136/jnnp.68.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Frasure-Smith N., Lespérance F., Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995 Feb 15;91(4):999–1005. doi: 10.1161/01.cir.91.4.999. [DOI] [PubMed] [Google Scholar]
  5. Lesperance F., Frasure-Smith N., Talajic M. Major depression before and after myocardial infarction: its nature and consequences. Psychosom Med. 1996 Mar-Apr;58(2):99–110. doi: 10.1097/00006842-199603000-00001. [DOI] [PubMed] [Google Scholar]
  6. Parikh R. M., Robinson R. G., Lipsey J. R., Starkstein S. E., Fedoroff J. P., Price T. R. The impact of poststroke depression on recovery in activities of daily living over a 2-year follow-up. Arch Neurol. 1990 Jul;47(7):785–789. doi: 10.1001/archneur.1990.00530070083014. [DOI] [PubMed] [Google Scholar]
  7. Ron M. A., Feinstein A. Multiple sclerosis and the mind. J Neurol Neurosurg Psychiatry. 1992 Jan;55(1):1–3. doi: 10.1136/jnnp.55.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Spitzer R. L., Williams J. B., Gibbon M., First M. B. The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Arch Gen Psychiatry. 1992 Aug;49(8):624–629. doi: 10.1001/archpsyc.1992.01820080032005. [DOI] [PubMed] [Google Scholar]
  9. Spitzer R. L., Williams J. B., Kroenke K., Linzer M., deGruy F. V., 3rd, Hahn S. R., Brody D., Johnson J. G. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994 Dec 14;272(22):1749–1756. [PubMed] [Google Scholar]
  10. Sullivan M. D., LaCroix A. Z., Baum C., Grothaus L. C., Katon W. J. Functional status in coronary artery disease: a one-year prospective study of the role of anxiety and depression. Am J Med. 1997 Nov;103(5):348–356. doi: 10.1016/s0002-9343(97)00167-8. [DOI] [PubMed] [Google Scholar]
  11. Wells K. B., Burnam M. A., Leake B., Robins L. N. Agreement between face-to-face and telephone-administered versions of the depression section of the NIMH Diagnostic Interview Schedule. J Psychiatr Res. 1988;22(3):207–220. doi: 10.1016/0022-3956(88)90006-4. [DOI] [PubMed] [Google Scholar]
  12. Wells K. B., Stewart A., Hays R. D., Burnam M. A., Rogers W., Daniels M., Berry S., Greenfield S., Ware J. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):914–919. [PubMed] [Google Scholar]
  13. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

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