TY - JOUR
T1 - Natural history of diagnostic interview schedule/DSM-IV major depression
T2 - The Baltimore Epidemiologic Catchment Area follow-up
AU - Eaton, William W.
AU - Anthony, James C.
AU - Gallo, Joseph
AU - Cai, Guojun
AU - Tien, Allen
AU - Romanoski, Alan
AU - Lyketsos, Constantine
AU - Chen, Li Shiun
PY - 1997
Y1 - 1997
N2 - Background: Natural history can be characterized by incidence, recurrence, and duration of episodes. Research on the incidence of major depression is rare; studies of recurrence and duration are limited to clinical samples. Methods: The Baltimore, Md, site of the Epidemiologic Catchment Area Program followed up its 1981 baseline cohort of 3481 respondents with an additional assessment in 1993 to 1996. Interviews were obtained from 1920 respondents (73% of the survivors). The Diagnostic Interview Schedule and the same survey procedures as in 1981 were used, augmented with a Life Chart Interview for dating the onset and duration of syndromes. Results: There were 71 new cases of Diagnostic Interview Schedule/DSM-IV major depression and 23 698 person-years of exposure, generating an estimated incidence of 3.0 per 1000 per year. Incidence peaked while subjects were in their 30s, with a smaller peak when they were in their 50s. Prodromal symptoms often occurred many years before the full criteria for diagnosis were met. Women were at higher risk for becoming new cases but had neither higher risk for recurrence nor longer episodes than men. Episodes of depression lasted for 12 weeks. The duration of an episode, and time to an episode-free year, was longer in the first episode than in recurrent episodes. Conclusions: The incidence estimated in this study is consistent with that found in the few other similar studies performed. The bimodality of onset suggests the value of further exploring the heterogeneity of depression via its natural history. Reported differences in prevalence between men and women seem to be due to differences in incidence, not chronicity.
AB - Background: Natural history can be characterized by incidence, recurrence, and duration of episodes. Research on the incidence of major depression is rare; studies of recurrence and duration are limited to clinical samples. Methods: The Baltimore, Md, site of the Epidemiologic Catchment Area Program followed up its 1981 baseline cohort of 3481 respondents with an additional assessment in 1993 to 1996. Interviews were obtained from 1920 respondents (73% of the survivors). The Diagnostic Interview Schedule and the same survey procedures as in 1981 were used, augmented with a Life Chart Interview for dating the onset and duration of syndromes. Results: There were 71 new cases of Diagnostic Interview Schedule/DSM-IV major depression and 23 698 person-years of exposure, generating an estimated incidence of 3.0 per 1000 per year. Incidence peaked while subjects were in their 30s, with a smaller peak when they were in their 50s. Prodromal symptoms often occurred many years before the full criteria for diagnosis were met. Women were at higher risk for becoming new cases but had neither higher risk for recurrence nor longer episodes than men. Episodes of depression lasted for 12 weeks. The duration of an episode, and time to an episode-free year, was longer in the first episode than in recurrent episodes. Conclusions: The incidence estimated in this study is consistent with that found in the few other similar studies performed. The bimodality of onset suggests the value of further exploring the heterogeneity of depression via its natural history. Reported differences in prevalence between men and women seem to be due to differences in incidence, not chronicity.
UR - http://www.scopus.com/inward/record.url?scp=0030689803&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030689803&partnerID=8YFLogxK
U2 - 10.1001/archpsyc.1997.01830230023003
DO - 10.1001/archpsyc.1997.01830230023003
M3 - Article
C2 - 9366655
AN - SCOPUS:0030689803
SN - 0003-990X
VL - 54
SP - 993
EP - 999
JO - Archives of general psychiatry
JF - Archives of general psychiatry
IS - 11
ER -