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The British Journal of Psychiatry (2004) 184: 153-156
© 2004 The Royal College of Psychiatrists

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

Lars Vedel Kessing, MD DMSc

Department of Psychiatry, University of Copenhagen (Department of Psychiatry, Rigshospitalet, Blegdamsvej 9, DK 2100 Copenhagen Ø, Denmark. Tel: 3545 6237; fax: 3545 6218; e-mail: lars.kessing{at}rh.dk) and Department of Psychiatric Demography, University of Aarhus, Risskov, Denmark

Declaration of interest None.

Funding detailed in Acknowledgements.

Background The ICD-10 categorisation of severity of depression into mild, moderate and severe depressive episodes has not been validated.

Aims To validate the ICD-10 categorisation of severity of depression by estimating its predictive ability on the course of illness and suicidal outcome.

Method All 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.

Results At 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.

Conclusions The ICD-10 way of grading severity is clinically useful and should be preserved in future versions.


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