Table 1.
Clinical characteristics of the recurring-episode and resilient MDD patients a
| Recurring episode MDD (n = 17) | Resilient MDD (n = 30) | |
|---|---|---|
| Past MDD subtype, n | ||
| With melancholic features | 9 | 17 |
| With atypical features | 0 | 2 |
| No specific subtype | 8 | 11 |
| Number of previous MDEs, n | ||
| 1 | 1 | 13 |
| 2 | 5 | 5 |
| 3 | 2 | 9 |
| 4 | 4 | 1 |
| 5 | 3 | 2 |
| 6 or more | 2 | 0 |
| Average number of previous MDEs* | 3.7 (2.0, 1–9) | 2.1 (1.2, 1–5) |
| Last and most severe MDE details | ||
| Average length of MDE, months | 17.7 (25.2, 1–96) | 15.3 (18.8, 1–81) |
| Average time in remission, months | 21.5 (20.9, 6–72) | 37.9 (53.8, 6–282) |
| Average MADRS score for MDE | 34.6 (5.2, 24–44) | 35.1 (5.7, 20–44) |
| No psychotropic medication since, months | 42.7 (54.4, 2–173) | 60.0 (86.5, 3–372) |
| Previous treatment, n | ||
| SSRI antidepressant | 15 | 25 |
| SNRI antidepressant | 0 | 1 |
| Tricyclic antidepressant | 0 | 2 |
| Mirtazapine | 1 | 0 |
| Unknown class of antidepressant | 3 | 3 |
| Benzodiazepines only | 0 | 1 |
| No antidepressant medication | 1 | 2 |
| CBT | 6 | 6 |
| Self-guided CBT via Internet, books | 0 | 3 |
| Counselling | 6 | 14 |
| Suicide attempts | 0.18 (0.53, 0–2) | 0.20 (0.61, 0–3) |
| Lifetime Axis I co-morbidity b , n | ||
| Panic disorder with agoraphobia | 1 | 0 |
| Bulimia nervosa | 0 | 1 |
| No lifetime co-morbidity | 16 | 29 |
| Family history, n | ||
| First-degree relative with MDD | 10 | 16 |
| No family member with history of MDD | 6 | 11 |
| First-degree relative with schizophrenia or bipolar disorder | 1 | 3 |
Data are given as mean (standard deviation, range) unless otherwise indicated.
MDD, Major depressive disorder; MDE, major depressive episode; MADRS, Montgomery–Åsberg Depression Rating Scale; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin norepinephrine reuptake inhibitor; CBT, cognitive–behavioural therapy.
All MDD patients stopped medication before the required washout phase. Recurring-episode and resilient MDD patients did not significantly differ on past MDD subtype, average length of the last MDE, average time in remission, average MADRS score for the last MDE, average time since last taking psychotropic medications, number of patients previously treated, number of suicide attempts, lifetime Axis I co-morbidity, or family history (contingency coefficient < 0.20, p > 0.18; t < 1.21, p > 0.23). There were also no differences between the resilient and recurring-episode MDD patients regarding previous treatment with SSRIs, SNRIs, tricyclics, mirtazapine or CBT (contingency coefficient < 0.20, p > 0.17).
All co-morbid disorders were fully remitted at the time of study and none was likely to be the primary cause of the depressive episodes.
Significantly different between the recurring-episode and resilient MDD groups (t45 = 3.39, p = 0.001).