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The British Journal of Psychiatry (2004) 185: 372-377
© 2004 The Royal College of Psychiatrists

Course of illness in depressive and bipolar disorders

Naturalistic study, 1994–1999

Lars Vedel Kessing, MD, DMSc

Department of Psychiatry, University of Copenhagen, Risskov, Denmark

Mette Gerster Hansen, BSc and Per Kragh Andersen, MSc, PhD, DMSc

Department of Biostatistics, University of Copenhagen, and Department of Psychiatric Demography, University of Aarhus, Psychiatric Hospital, Risskov, Denmark

Correspondence: Professor Lars Vedel Kessing, Department of Psychiatry, Rigshospitalet, Blegdamsvej 9, DK 2100 Copenhagen Ø, Denmark. Tel: 3545 6168; fax: 3545 6218; e-mail: lars.kessing{at}rh.dk

Declaration of interest None. Funding detailed in Acknowledgement.

Background Newer antidepressants have increasingly been used during the past decade. These drugs may increase compliance and reduce the risk of cycle acceleration in affective disorders.

Aims To investigate the naturalistic longitudinal course of illness in patients with depressive or bipolar disorder following the use of recently introduced drugs.

Method The rates of relapse leading to hospitalisation after successive episodes were calculated in a case register study including all hospital admissions of patients with primary affective disorder in Denmark during 1994–1999. Altogether, 9417 patients had a diagnosis of depressive disorder and 1106 patients had a diagnosis of mania or bipolar disorder, at first-ever discharge.

Results The rate of relapse leading to hospitalisation increased with the number of previous episodes in both depressive and bipolar disorders. However, the effect of episodes was not significant for men. The rate of relapse did not decline during the study period.

Conclusions The course of severe depressive and bipolar disorders has remained roughly the same despite introduction of new treatments.




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