An 11‐year follow‐up study of 110 depressed patients

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Abstract
In 1972 the World Health Organization organized a cross‐cultural five‐centre study of depressive disorders. This report is concerned with data collected, after an 11‐year follow‐up period, in the sample of 110 depressed patients in Montreal, Canada. Eighty‐five percent were traced and 59% were interviewed. Of 93 patients, 20 were dead at the follow‐up date, 11 by suicide. Fifty‐two percent of patients were receiving psychiatric treatment at follow‐up, but there was no relation between psychiatric morbidity and treatment‐seeking. Moderate or severe impairment of social functioning was present in 32%; in women, a trend linking the presence of social impairment and the time spent in episodes was observed. Of the episodes of psychiatric illness recorded after the index episode, 86% were diagnosed as depressive, 14% as unspecified affective disorder. The mean durations of the index and four subsequent episodes were 10, 11, 7, 11, and 2 months respectively. At least one recurrence after the index episode was reported by 78%, at least four recurrences by 19%. Episodes lasted at least one year in 5%, 4%, 6%, and 6% in the first, second, third and fourth episodes respectively. Sixteen percent were depressed for at least one year and 31% for at least 2 years. There was a marked trend from inpatient to outpatient treatment and from ECT to drug therapy over time. Twenty‐two percent reported either moderate or severe problems with alcohol or substance abuse. There was a statistically significant association between the amount of time patients spent in depressive episodes and the number of life events they reported. Many more depressed patients in the “neurotic” diagnostic group than in the “endogenous” group lived alone; patients in the “neurotic” group also reported more life events. On the other hand, more “endogenous” patients were receiving psychiatric treatment at follow‐up.

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