The Long-Term Outcome of Maudsley Depressives

1988 ◽  
Vol 153 (6) ◽  
pp. 741-751 ◽  
Author(s):  
Alan S. Lee ◽  
Robin M. Murray
Keyword(s):  
Function Analysis ◽  
Depressive Illness ◽  
Index Admission ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Unnatural Death ◽  
Admission Data ◽  
High Incidence ◽  
Poor Outcomes

Eighty-nine consecutive admissions with primary depressive illness were prospectively ascertained and diagnosed in 1965–66 by R. E. Kendell, who also allocated each a position on a neurotic-psychotic continuum on the basis of previous discriminant function analysis. In 1983–84, 94% of the survivors were personally interviewed by a psychiatrist blind to index admission data. Operational outcome criteria were employed and longitudinal data were established for 98% of the series. Mortality risk was doubled overall, and increased sevenfold for women under 40 years at index admission. Less than one-fifth of the survivors had remained well, and over one-third of the series suffered unnatural death or severe chronic distress and handicap. Patients whose index episode marked their first psychiatric contact had a 50% chance of readmission within their lifetime, but those with previous admissions had a 50% chance of readmission within three years. Readmissions occurred even after 12 years of being symptom-free, and conversely patients recovered after as long as 15 years of illness. There was a high incidence of other disorders (schizoaffective disorder, alcoholism, schizophrenia), and only four patients showed pure recurrent unipolar histories. Patients at the psychotic end of the continuum were more likely to be readmitted and to have very poor outcomes.

The Long-Term Outcome of Depressive Illness

1988 ◽  
Vol 153 (6) ◽  
pp. 752-757 ◽  
Author(s):  
L. G. Kiloh ◽  
Gavin Andrews ◽  
Megan Neilson
Keyword(s):  
Endogenous Depression ◽  
Depressive Illness ◽  
Index Admission ◽  
University Hospital ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Considerable Morbidity ◽  
Adequate Data

One hundred and forty-five patients with primary depressive illness admitted to a university hospital between 1966 and 1970 were followed up an average of 15 years later. Adequate data were obtained on 133 (92%) of the 145. During the follow-up period, 7% of the 133 had suicided, 12% had remained incapacitated by illness and only 20% had remained continuously well. Patients for whom the index admission was not their first were especially likely to be readmitted during the follow-up period. Patients with endogenous depression, none of whom developed schizophrenia during the follow-up period, were more likely to need readmission than patients with an index diagnosis of neurotic depression. In all other respects the prognosis for the two types of depression was the same, with considerable morbidity evident in both.

scholarly journals Cytokine-Laden Extracellular Vesicles Predict Patient Prognosis after Cerebrovascular Accident

2021 ◽  
Vol 22 (15) ◽  
pp. 7847
Author(s):  
Anthony Fringuello ◽  
Philip D. Tatman ◽  
Tadeusz Wroblewski ◽  
John A. Thompson ◽  
Xiaoli Yu ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Inflammatory Cytokines ◽  
Hemorrhagic Stroke ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Interleukin 7 ◽  
Poor Outcomes ◽  
Patient Prognosis ◽  
The Brain

Background: A major contributor to disability after hemorrhagic stroke is secondary brain damage induced by the inflammatory response. Following stroke, global increases in numerous cytokines—many associated with worse outcomes—occur within the brain, cerebrospinal fluid, and peripheral blood. Extracellular vesicles (EVs) may traffic inflammatory cytokines from damaged tissue within the brain, as well as peripheral sources, across the blood–brain barrier, and they may be a critical component of post-stroke neuroinflammatory signaling. Methods: We performed a comprehensive analysis of cytokine concentrations bound to plasma EV surfaces and/or sequestered within the vesicles themselves. These concentrations were correlated to patient acute neurological condition by the Glasgow Coma Scale (GCS) and to chronic, long-term outcome via the Glasgow Outcome Scale-Extended (GOS-E). Results: Pro-inflammatory cytokines detected from plasma EVs were correlated to worse outcomes in hemorrhagic stroke patients. Anti-inflammatory cytokines detected within EVs were still correlated to poor outcomes despite their putative neuroprotective properties. Inflammatory cytokines macrophage-derived chemokine (MDC/CCL2), colony stimulating factor 1 (CSF1), interleukin 7 (IL7), and monokine induced by gamma interferon (MIG/CXCL9) were significantly correlated to both negative GCS and GOS-E when bound to plasma EV membranes. Conclusions: These findings correlate plasma-derived EV cytokine content with detrimental outcomes after stroke, highlighting the potential for EVs to provide cytokines with a means of long-range delivery of inflammatory signals that perpetuate neuroinflammation after stroke, thus hindering recovery.

Diagnosis, Personality and the Long-term Outcome of Depression

1990 ◽  
Vol 157 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Gavin Andrews ◽  
Megan Neilson ◽  
Caroline Hunt ◽  
Gavin Stewart ◽  
L. G. Kiloh
Keyword(s):  
Endogenous Depression ◽  
Index Admission ◽  
Term Outcome ◽  
Long Term Outcome

Patients diagnosed in the late 1960s as suffering from either endogenous or neurotic depression, or as presenting with depression but discharged with another neurotic diagnosis, were followed for 15 years. Diagnosis at index admission did not predict overall outcome, but patients with endogenous depression, an apparently stable diagnosis, had longer index admissions, were readmitted sooner, but spent less time ill than patients in either of the neurosis groups. Personality abnormality accounted for 20% of the variance in outcome in the neurotic groups and only 2% of the variance in the endogenous group. Thus there is evidence that endogenous and neurotic depression are two illnesses and that, in the neuroses particularly, prognosis will depend on the extent to which these personality abnormalities are modified by treatment.

Future Imperfect: the Long-Term Outcome of Depression

1994 ◽  
Vol 164 (3) ◽  
pp. 327-341 ◽  
Author(s):  
P. G. Surtees ◽  
C. Barkley
Keyword(s):  
Depressive Illness ◽  
Consecutive Series ◽  
Longitudinal Assessment ◽  
Short Term ◽  
Term Outcome ◽  
Entire Study ◽  
Long Term Outcome ◽  
History Of

During 1976, 80 patients with a primary depressive illness were selected from a consecutive series of referrals to the Royal Edinburgh Hospital for a short-term follow-up study. This paper concerns the 12-year longitudinal assessment of the survivors. During the follow-up, mortality risk for the sample was almost doubled. Of the series, 35% had experienced a recurrence within 2 years of the initial interview, and just over 60% within the entire study time of 12 years. The risk of recurrence was enhanced for those aged over 45 years at index, for those with a history of depressive disorder and for those who had not engaged in parasuicidal behaviour during the index episode. The observed effect of previous episodes was largely accounted for by age. The chance of recurrence was not affected by whether the treatment of the index episode included ECT, or by whether diagnosis was ‘endogenous’ or ‘neurotic’. Application of the Lee-Murray outcome criteria showed that about one-third of the Edinburgh series experienced a very poor outcome. Results are presented concerning the prediction of long-term outcome as represented by the Depression Outcome Scale (DOS), a measure specially constructed for this study.

scholarly journals Sarcoidosis: Psychotherapy and Long-Term Outcome—A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Giancarlo Trombini ◽  
Elena Trombini
Keyword(s):  
Depressive Symptoms ◽  
Stressful Life Events ◽  
Stressful Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Systemic Inflammatory Disease ◽  
High Incidence ◽  
Supportive Expressive Psychotherapy ◽  
Outcome Evaluations

Sarcoidosis is a systemic, inflammatory disease of unknown aetiology, influenced by stressful life events and associated with a high incidence of alexithymic personality traits, and of depressive symptoms. The medical literature on sarcoidosis has called for a psychotherapeutic intervention to modify the perceived state of disease, the influence of stressful events and the depressive condition. Few studies have described cases treated with psychotherapy, and no information is available on its long-term outcome. We present the case of a patient with chronic sarcoidosis and periodical reacutizations with constantly pathological ESR. Twenty-four years after the diagnosis, a dynamic supportive-expressive psychotherapy for psychosomatic alexithymic patients was added to the medical therapy. At the beginning and at the end of the psychotherapy, and for the long-term outcome evaluations, Kellner’s symptom questionnaire (SQ) was used to investigate psychological distress. The SQ scores, initially pathological, were normal at the end of the psychotherapy and for the following three years. Psychotherapy, without antidepressive drugs, resolved the depression. The depressive symptoms disappeared, along with the normalization and stabilization of the ESR. After three years, the outcome was positive. This is the first study describing a successful psychotherapy and its long-term outcome on a patient with sarcoidosis.

scholarly journals Long-term outcome following bilateral lateral rectus recession for intermittent exotropia

2014 ◽  
Vol 8 (4) ◽  
pp. 565-568
Author(s):  
Jutima Patlidanon ◽  
Parnchat Pukrushpan ◽  
Supharat Jariyakosol ◽  
Pokpong Praneeprachachon
Keyword(s):  
Lateral Rectus ◽  
Success Rates ◽  
Intermittent Exotropia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Motor Outcome ◽  
Ocular Deviation ◽  
Poor Outcomes

Abstract Background: Bilateral lateral rectus recession is the most common surgical treatment of intermittent exotropia in children. Success rates in previous studies differ because longer follow-up periods may change success rate as the eyes drift out with time. Initial overcorrection was thought to be appropriate management, but the preferred initial postoperative deviation has not been well quantified. Objective: To study long-term outcomes (≥3 years) of bilateral lateral rectus recession for intermittent exotropia and to evaluate factors influencing long-term success. Methods: This retrospective descriptive study reviews patients with intermittent exotropia who underwent bilateral lateral rectus recession with a minimum follow up of 3 years. Long-term motor outcome was classified as good (within 8 prism diopters (PD) of esodeviation and 10 PD of exodeviation), acceptable (exodeviation 11-20 PD), and poor (esotropia >8 PD or exotropia >20 PD). Stereoacuity testing pre- and postoperatively was used to evaluate sensory outcome. Correlation between long-term outcome and various pre- and postoperative factors were analyzed. Results: A total of 59 patients met the selective inclusion criteria. The mean age at time of surgery was 7.1 years with a mean follow-up time of 4.5 years. At the time of the last visit, 69% (41 patients) had good outcomes, 24% (14 patients) had acceptable outcomes, and 7% (4 patients) had poor outcomes. Initial postoperative ocular deviation significantly correlated with long-term outcome (P < 0.05). Mean initial postoperative ocular deviation of patients with good outcome was esodeviation 12.7 PD (range ortho to esodeviation 25 PD). In 45 patients whose stereoacuity could be assessed, 58% (26 patients) had stereoacuity improvement. Conclusion: Good long-term motor outcome can be achieved in 69% of patients following bilateral lateral rectus recession for intermittent exotropia. Initial postoperative ocular deviation correlated with long-term motor success.

An evaluation of the Feighner criteria for schizophrenia and affective disorders using long-term outcome data

1981 ◽  
Vol 11 (2) ◽  
pp. 281-287 ◽  
Author(s):  
Ming T. Tsuang ◽  
Robert F. Woolson ◽  
John C. Simpson
Keyword(s):  
Affective Disorders ◽  
Outcome Data ◽  
Index Admission ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Poor Outcome ◽  
Bipolar Patients

SynopsisSchizophrenia and affective disorders selected according to the Feighner criteria can be differentiated on the basis of 40-year outcome. Within schizophrenia the presence of disorganized thoughts at the index admission was associated with poor outcome, whereas better outcome was associated with the presence of delusions or hallucinations. Within the affective disorders, bipolar patients with grandiose delusions or ideas showed a poor outcome; a better outcome was found in unipolar patients with complaints of fatiguability or tiredness at the time of the index admission.

scholarly journals Characteristics and outcomes associated with 30-day readmissions following acute coronary syndrome 2000–2013: the Acute Coronary Syndrome Israeli Survey

2018 ◽  
Vol 8 (8) ◽  
pp. 738-744
Author(s):  
Ilia Litovchik ◽  
David Pereg ◽  
Nir Shlomo ◽  
Dina Vorobeichik ◽  
Roy Beigel ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Unplanned Readmission ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Coronary Syndrome ◽  
The Past ◽  
Strong Trend ◽  
Poor Outcomes

Background: Readmissions following acute myocardial infarction are associated with poor outcomes and a heavy economic burden. There are few evidence-based data on the characteristics and outcomes of patients readmitted following acute coronary syndrome. We explored the incidence and outcomes of patients readmitted after an acute coronary syndrome in the past decade. Methods: The study population comprised all acute coronary syndrome patients who were enrolled and prospectively followed up in the biennial Acute Coronary Syndrome Israeli Survey from 2000 to 2013. Multivariate analysis identified factors independently associated with readmission and long-term mortality. Results: There were 13,010 study patients, of whom 556 (4.2%) had an unplanned readmission within 30 days of the index event. Stent thrombosis during the index hospitalisation (odds ratio (OR) 8.43; 95% confidence interval (CI) 4.11–16.07; P<0.001), female sex (OR 1.34; 95% CI 1.1–1.63; P=0.003), older age (>65 years; OR 1.28; 95% CI 1.06–1.55; P=0.011), and lack of dual-antiplatelet therapy (OR 1.52; 95% CI 1.25–1.86; P<0.001) were independently associated with readmission. Readmitted patients were less likely to have been treated with guideline-directed medical therapy during hospitalisation and at discharge, and were less likely to have undergone coronary angiography. A strong trend towards decline in readmission rates following acute coronary syndrome was observed between 2000 and 2013 ( P<0.001). However, the association between readmission and poor long-term outcome was more pronounced among patients readmitted during more recent years (2008–2013). Conclusions: Patients readmitted to hospital following acute coronary syndrome comprise an undertreated, high-risk cohort. Our findings indicate that despite a significant decline in readmission rates following acute coronary syndrome over the past decade, readmission within 30 days following acute coronary syndrome still portends a grave outcome.

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