Continuities And Discontinuities In Depression Continuities in the short term

Many studies of clinical samples have reported that young people with a depressive disorder have a high risk of recurrence or persistence (Asarnow et al., 1988; Emslie et al., 1997b; Goodyer et al., 1991; 1997b; Kovacs et al., 1984a; McCauley et al., 1993). For example, Kovacs and colleagues (Kovacs et al., 1984a) undertook a systematic follow-up of child patients with a major depressive disorder, a dysthymic disorder, an adjustment disorder with depressed mood, and some other psychiatric disorder. The development of subsequent episodes of depression was virtually confined to children with major depressive disorders and dysthymic disorders. Thus, within the first year at risk, 26% of children who had recovered from major depression had had another episode; by 2 years this figure had risen to 40%; and by 5 years the effected cohort ran a 72% risk of another episode! On long-term follow-up, major depression and dysthymia were associated with similar rates of most outcomes (Kovacs et al., 1994).

Surveys of community samples have generally also found that depressive disorders among young people tend to be recurrent (Fleming et al., 1993; Garrison et al., 1997; Lewinsohn etal., 1993; 1994a; McGeeetal., 1992; McGee & Williams, 1988). For instance, Lewinsohn et al. (1993; 1994a) found that the 1-year relapse rate for unipolar depression (18.4%) was much higher than the relapse rate found in most other disorders. Interestingly, among adolescents in that study who experienced two episodes of depression, there was low concordance across episodes in the symptoms of depression (Roberts et al., 1995). Only one community study has failed to find significant continuity for depressive disorder (Cohen et al., 1993a; 1993b).

Similarly, investigators of the short-term stability of questionnaire ratings of depressive symptoms in community samples of young people have also found significant correlations over time (Charman, 1994; Edelsohn et al., 1992; Garrison et al., 1990; Larsson etal., 1991; Stanger et al., 1992).

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