scholarly journals Severity of depressive episodes according to ICD-10: prediction of risk of relapse and suicide

2004 ◽  
Vol 184 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Lars Vedel Kessing

BackgroundThe ICD–10 categorisation of severity of depression into mild, moderate and severe depressive episodes has not been validated.AimsTo validate the ICD–10 categorisation of severity of depression by estimating its predictive ability on the course of illness and suicidal outcome.MethodAll psychiatric in-patients in Denmark who had received a diagnosis of a single depressive episode at their first discharge between 1994 and 1999 were identified. The risk of relapse and the risk of suicide were compared for patients discharged with an ICD–10 diagnosis of a single mild, moderate or severe depressive episode.ResultsAt their first discharge, 1103 patients had an ICD–10 diagnosis of mild depressive episode, 3182 had a diagnosis of moderate depressive episode and 2914 had a diagnosis of severe depressive episode. The risk of relapse and the risk of suicide were significantly different for the three types of depression – increasing from mild to moderate to severe depressive episode.ConclusionsThe ICD–10 way of grading severity is clinically useful and should be preserved in future versions.

2008 ◽  
Vol 192 (4) ◽  
pp. 290-293 ◽  
Author(s):  
Lars Vedel Kessing

BackgroundIt is not clear whether the severity of depressive episodes changes during the course of depressive disorder.AimsTo investigate whether the severity of depressive episodes increases during the course of illness.MethodUsing a Danish nationwide case register, all psychiatric inpatients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994–2003.ResultsA total of 19 392 patients received a diagnosis of a single depressive episode at first contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact and calendar year.ConclusionsThe increasing severity of depressive episodes emphasises the importance of early and sustained prophylactic treatment.


2002 ◽  
Vol 32 (4) ◽  
pp. 595-607 ◽  
Author(s):  
K. BARKOW ◽  
W. MAIER ◽  
T. B. ÜSTÜN ◽  
M. GÄNSICKE ◽  
H.-U. WITTCHEN ◽  
...  

Background. Studies that examined community samples have reported several risk factors for the development of depressive episodes. The few studies that have been performed on primary care samples were mostly cross-sectional. Most samples had originated from highly developed industrial countries. This is the first study that prospectively investigates the risk factors of depressive episodes in an international primary care sample.Methods. A stratified primary care sample of initially non-depressed subjects (N = 2445) from 15 centres from all over the world was examined for the presence or absence of a depressive episode (ICD-10) at the 12 month follow-up assessment. The initial measures addressed sociodemographic variables, psychological/psychiatric problems and social disability. Logistic regression analysis was carried out to determine their relationship with the development of new depressive episodes.Results. At the 12-month follow-up, 4·4% of primary care patients met ICD-10 criteria for a depressive episode. Logistic regression analysis revealed that the recognition by the general practitioner as a psychiatric case, repeated suicidal thoughts, previous depressive episodes, the number of chronic organic diseases, poor general health, and a full or subthreshold ICD-10 disorder were related to the development of new depressive episodes.Conclusions. Psychological/psychiatric problems were found to play the most important role in the prediction of depressive episodes while sociodemographic variables were of lower importance. Differences compared with other studies might be due to our prospective design and possibly also to our culturally different sample. Applied stratification procedures, which resulted in a sample at high risk of developing depression, might be a limitation of our study.


1994 ◽  
Vol 165 (3) ◽  
pp. 399-403 ◽  
Author(s):  
Sally-Ann Cooper ◽  
Richard A. Collacott

BackgroundDepression occurs commonly in people with Down's syndrome, although there is little published about this association. This study explores the limitations of Diagnostic Criteria for Research, based on ICD-10 (DCR) and DSM–III–R depressive criteria.MethodCase note examination identified 42 adults with Down's syndrome who have sustained 56 depressive episodes. The clinical features are reported.ResultsAll episodes were diagnosed as depression. DSM–III–R criteria for major depressive episode were met by 50% of the episodes. DCR for depressive episode of at least mild severity were fulfilled by 68%.ConclusionsThese criteria were unduly restrictive for this group. Commonly occurring symptoms are not included in the criteria, while certain criteria items never occurred. Criteria should be modified to facilitate future research.


2001 ◽  
Vol 13 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Daniel W. O'Connor ◽  
Richard Rosewarne ◽  
Ann Bruce

Background: This article examines some of the factors responsible for older patients' decision to report current depressive symptoms to their general medical practitioner. A companion article considers factors contributing to general practitioners' (GPs') recognition of major depressive episode when it was present. Methods: A survey was conducted of a stratified sample of 1,021 patients aged 70+ years of 30 GPs in Melbourne, Australia, to gauge the prevalence of depressive symptoms, the frequency with which patients had informed GPs of their symptoms, and GPs' recognition of major depressive episodes. Patients and informants were questioned using the Canberra Interview for the Elderly, which generates rigorous ICD-10 research diagnoses. Results: Logistic regression analysis showed that symptom disclosure was associated in descending order of importance with higher depressive scores, previous contact with a psychiatrist, and female gender. Even so, 48% of persons with ICD-10 moderate or severe depressive episode had not reported any current complaints to their doctor at the time of interview. Conclusion: Older patients often do not report depressive symptoms to their medical practitioner. Men and patients lacking “psychological mindedness” may be at special risk.


1970 ◽  
Vol 6 (3) ◽  
pp. 340-345 ◽  
Author(s):  
SN Pradhan ◽  
SR Adhikary ◽  
SC Sharma

Objective: The aim of the work was to study the socio-demographic variables and their co-morbidity to alcohol consumption and presence of depressive symptomatology. Design: This was a prospective cross-sectional study. Materials and methods: The study was carried out in 53 patients, who were admitted in the wards of Kathmandu Medical College Teaching Hospital (KMCTH) with the diagnosis of mental and behavioural disorder due to the use of alcohol according to ICD-10. The patients were taken from 1st February 2006 to 30th December 2006. All patients were rated using Hamilton Depression Rating Scale (HDRS). Comparison of alcohol intake, depressive symptomatology and their associations with various socio-demographic variables were done using standard statistical procedures. Results: The present study has shown that more than 94.3% of the patients were suffering from depressive episode. Among all the patients, 11.3% were suffering from severe depressive episode. Alcohol intake was more significantly correlated (p = .002) with Brahmin and Chhetri caste. The other significant correlation of alcohol intake and sociodemographic variable was Nuclear family (p=.001). Among these patients the severity of depression was significantly (p= .001) associated with duration of alcohol intake. Marital status was another important factor affecting comorbidity of alcohol intake and presence of depressive symptoms (p =.002). Students of 10th to 12th grades of school were found to be using alcohol more often (45.3%). Middle socio-economic status (60.4%) was using alcohol more frequently than other socioeconomical classes. Conclusion: Severity of depression and alcohol intake was found to be significantly associated with various socio-demographic variables such as caste, family structure, marital status and educational status. Key words: Co-morbidity, ICD-10, Depression, alcohol-related disorders doi: 10.3126/kumj.v6i3.1709 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 340-345


2017 ◽  
Vol 41 (S1) ◽  
pp. S532-S532
Author(s):  
S. Lukmonov ◽  
N. Yadgarova

ObjectiveTo study the clinical - psychopathological characteristics of patients with resistant depression.Materials and methodsWe examined 96 patients aged 18–48 years (mean age 34.7 0 ± 1.0 years). The investigated patients were divided into two groups: 1st -TRD with positive affectivity - 59 (61.4%); 2nd - curable depression - 37 (38.6 %). Selection of patients was made according to following criteria: ICD - 10: (F31) - bipolar disorder; (F32) - depressive episode; (F33) - recurrent depressive disorder.ResultsIn group 1 patients received amitriptyline (TCA) - 50 mg - 2 times/day in one of 2 consecutive courses (within 6 weeks) and they showed no clinical benefit. In group 2 patients received amitriptyline - 50 mg 2 times/day for 2 consecutive courses. When analyzing the number of depressive episodes the statistically greater number was observed 1-3 episodes in group 2 - in 45.9% of patients than in group 1 - 16.9%, predominant 5-8 episodes - in 44.1% of patients in group 1, than in group 2 - 13.5%. Remissions, observed in group 2, were characterized by longer duration and have a higher quality than in patients of group 1. There is a tendency to shorten remission especially in group 1.ConclusionThe highest correlation dependence showed such factors as: frequency of depressive episodes, duration of episode 1, severity of depressive episode 1, quality of remission after depressive episode 1, number of responders at early stages of antidepressant therapy of I-st attack.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Psychiatry ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 34-41
Author(s):  
O. K. Savushkina ◽  
E. B. Tereshkina ◽  
T. A. Prokhorova ◽  
I. S. Boksha ◽  
T. P. Safarova ◽  
...  

The aim of the study is to evaluate the activity of platelet glutamate dehydrogenase (GDH) in late-life depression compared to the healthy control group and to reveal possible correlations with clinical data. Patients and methods: 42 elderly patients (60–86 years old) with depressive episodes of different nosological categories according to ICD-10 were examined: a single depressive episode (F32.0, F32.1), a depressive episode in recurrent depressive disorder (RDD — F33.0, F33.1) and a depressive episode in bipolar affective disorder (BD — F31.3). The activity of GDH and the severity of depression (using the Hamilton depressive scale, HAMD-17, and the Hamilton scale for assessing anxiety, HARS) were evaluated twice: before the starting the course of antidepressant therapy (day 0) and on the 28th day of the treatment course. Results: patients showed a significant decrease in the activity of GDH compared to the control group (p < 0.0008). Before the treatment, GDH activity was significantly reduced compared to the control in both RDD and BD (p < 0.002 and p < 0.004), whereas after the treatment, the decreased GDH activity was observed only in patients with BD (p < 0.002). When compared with the control group, male patients showed a significant decrease in GDH activity both before and after the treatment course (p < 0.017 and p < 0.027), whereas women patients showed the decrease only before the treatment (p < 0.014). Conclusion: the decreased platelet GDH activity in elderly depressions may indicate an impairment of glutamate metabolism. Gender differences were revealed in the reversal of GDH activity level after the therapy: in men, the level of GDH activity did not recover to control values after the treatment course. An elevation in the level of GDH to control values over a 28-day course of therapy occurred only in patients with RDD, but not in patients with BD.


2018 ◽  
Vol 6 (11) ◽  
pp. 2079-2083
Author(s):  
Slavica Arsova ◽  
Stojan Bajraktarov ◽  
Kadri Hadzihamza ◽  
Viktor Isijanovski

BACKGROUND: Mother’s mental state during pregnancy is of substantial importance for the mother, but also for the infant and his/her future growth and development. Depressive maternal disorders during pregnancy have a significant influence on the development of the baby during pregnancy as well as on the future development and mother-baby relation, the breastfeeding process and care for the baby. AIM: This study aimed to determine the influence of SSRI antidepressant therapy and psychosocial and therapeutic interventions on depression during pregnancy. It was also our aim to determine the relation between severity of depression and sociodemographic characteristics. METHODS: The study included 40 women, with diagnosis F32 and F33 according to ICD 10, that is, with severe depressive disorder within depressive episodes or recurrent depressive disorder. Patients were evaluated at the beginning of the treatment and 3 months after antidepressant treatment. They were followed-up for two years. RESULTS: The results obtained have shown that a larger number of mothers treated with antidepressant medications, had normal childbirth with the unremarkable condition of both, the mother and the newborn baby. CONCLUSION: A well-combined treatment of maternal depression during pregnancy reduces the risk of postpartum depression, which is by itself a prerequisite for normal emotional and behavioural development of the child.


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