A 2 and 3.5-year naturalistic follow-up study of patients with unipolar depressive disorders. [Uno studio naturalistico di follow-up a 2 e 3,5 anni in pazienti con disturbi depressivi unipolari].

Introduction. Studies on unipolar depression show high rate of relapse and a substantial risk of chronicization. Methods. 2 and 3.5-year follow-up assessment using a telephone clinical interview which included the GAF and the 15-items HAM-D (have been eliminated 2 items of visual valuation). Results. 116 subjects (42 m., 74 f.) who were included in the study are presented. During the first year, 25% dropped out soon after the first visit while 21% dropped out before being appropriately taken in charge by the psychiatric service. Only 17% showed a satisfactory course at the end of first 12 months. 86% of subjects who signed informed consent for the follow-up (n=100) were contacted after 2 years and 73% after 3.5-year follow-up. Fifty-one percent of patients had a recurrency, and 58 percent showed sub-threshold or residual symptoms after 3.5-year follow- up. The persistence of depressive symptoms was also associated to a higher incidence of intercurrent episodes, with a longer mean duration and worse GAF score. Discussion. Though effective antidepressive treatment had been appropriately prescribed to most patients, long-term outcome is still unsatisfactory, given that more than half of the sample had relapses and 46% still show residual depressive symptoms after two years. Long-term therapy of unipolar depression should therefore consider specific treatment of sub-threshold or residual symptoms that are not effectively relieved by drug treatment alone.