An 11‐year follow‐up study of 110 depressed patients

In 1972 the World Health Organization organized a cross-cultural five-centre study of depressive disorders. This report is concerned with data collected, after an 11-year follow-up period, in the sample of 110 depressed patients in Montreal, Canada. Eighty-five percent were traced and 59% were interviewed. Of 93 patients, 20 were dead at the follow-up date, 11 by suicide. Fifty-two percent of patients were receiving psychiatric treatment at follow-up, but there was no relation between psychiatric morbidity and treatment-seeking. Moderate or severe impairment of social functioning was present in 32%; in women, a trend linking the presence of social impairment and the time spent in episodes was observed. Of the episodes of psychiatric illness recorded after the index episode, 86% were diagnosed as depressive, 14% as unspecified affective disorder. The mean durations of the index and four subsequent episodes were 10, 11, 7, 11, and 2 months respectively. At least one recurrence after the index episode was reported by 78%, at least four recurrences by 19%. Episodes lasted at least one year in 5%, 4%, 6%, and 6% in the first, second, third and fourth episodes respectively. Sixteen percent were depressed for at least one year and 31% for at least 2 years. There was a marked trend from inpatient to outpatient treatment and from ECT to drug therapy over time. Twenty-two percent reported either moderate or severe problems with alcohol or substance abuse. There was a statistically significant association between the amount of time patients spent in depressive episodes and the number of life events they reported.(ABSTRACT TRUNCATED AT 250 WORDS)