Three- to 5-year prospective follow-up of outcome in major depression

Psychol Med. 1998 May;28(3):731-5. doi: 10.1017/s0033291797006466.


Background: A Dutch cohort of predominantly out-patient DSM-III-R major depressive patients was followed for 3 to 5 years after start of treatment in a psycho-neuro-endocrinological prediction study. The study design permitted description of the course of remissions, relapses and recurrences.

Methods: Pharmacological treatment was standardized, psychotherapy was tailored to the needs of the patient, follow-ups were done monthly until 3 years or more after the initial recruitment.

Results: After 9 months 49% of the patients had reached full remission and 45% were in partial remission. During the following 3 to 5 years 82% of the patients had reached a period of full remission. Sixteen per cent of the patients needed 2 years or more before full remission. A relapse or recurrence rate of 41% within 5 years was found. Patients with residual symptoms relapsed particularly in the first 4 months after remission, while patients without residual symptoms recurred mainly after 12 months after remission. Previous depressive episodes and psychoticism predicted relapse. Psychomotor retardation at inception predicted a longer time to partial remission.

Conclusion: In most cases, major depression is a seriously impairing episodic disease. This is also true for a sample of predominantly out-patients treated at a university clinic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care
  • Antidepressive Agents / therapeutic use*
  • Cohort Studies
  • Combined Modality Therapy
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / rehabilitation*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Psychotherapy*
  • Recurrence
  • Treatment Outcome


  • Antidepressive Agents