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Outcome in refractory depression.

S S Shergill·M M Robertson·G Stein·M Bernadt·C L Katona
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Abstract

BACKGROUND: Failure to respond to first-line antidepressant treatment can occur in up to 40% of patients with depressive illness. A proven strategy for managing this refractory depression is lithium augmentation. The long-term outcome and optimal management of patients treated with lithium augmentation remains unclear. We describe a 4-8 year naturalistic follow-up of patients treated with lithium augmentation in two controlled studies of its efficacy in refractory depression. METHOD: Cases were followed up with personal interview where possible, and by telephone and general practitioner contact otherwise. Lifetime clinical status was ascertained using the Schedule for Affective Disorders and Schizophrenia-Lifetime (SADS-L). RESULTS: We obtained outcome data on 53 of the original eligible 76 patients. There was a good outcome in 38 (72%) patients. Good outcome was associated with a less endogenous nature of depression and an absence of previous hospitalisations. CONCLUSIONS: There do not seem to be any specific prognostic indicators of long-term outcome to lithium augmentation beyond those recognised to be relevant in the outcome of depression generally. LIMITATIONS: The conclusions are limited by incomplete follow-up of the total original sample and lack of objective illness and medication data for the intervening period.

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AdultAgedDepressive DisorderFemaleFollow-Up StudiesHumansLithiumMaleMiddle AgedPrognosisRecurrenceTreatment OutcomeJournal Article

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S S Shergill, M M Robertson, G Stein, M Bernadt, C L Katona. 1999. Outcome in refractory depression.. https://doi.org/10.1016/s0165-0327(98)00201-8

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