This paper analyses data from a large observational study of the course of affective illness to provide insight into the duration and dose of effective maintenance therapies.
The data are 236 unipolar patients who had received antidepressants during recovery and were followed for affective recurrence for up to 5 years.
Using data on the naturally selected somatic treatments, we have conducted analyses that adjust for the potential confounding effects of prognosis and treatment intensity to estimate the causal effect of level of medication on the course of recurrence.
The results of these analyses show that it is important for patients to remain on the level of somatotherapy used to treat the acute episode for the initial 8 months after symptoms have abated.
After that time, the rate of recurrence for patients with fewer than five previous episodes is approximately 1% per week or less at all levels of medication (including discontinuation).
Patients who had experienced more than several recurrences are at greater risk of recurrence and continue to benefit from any level of medication during the first year after recovery.
The CDS analyses reported here suggest that effective maintenance strategies for all but highly recurrent patients may be a middle road, opting for full-dose strategies of limited duration. (...)
Mots-clés Pascal : Etat dépressif, Traitement, Chimiothérapie, Antidépresseur, Psychotrope, Prévention, Récidive, Santé mentale, Etude longitudinale, Homme, Trouble humeur
Mots-clés Pascal anglais : Depression, Treatment, Chemotherapy, Antidepressant agent, Psychotropic, Prevention, Relapse, Mental health, Follow up study, Human, Mood disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0224835
Code Inist : 002B02B02. Création : 11/09/1998.