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Can one predict the long-term outcome of hospitalized depressives?

Institute of Psychiatry and King's College Hospital, de Crespigny Park, London SE5 8AF, UK

Connor Duggan

Institute of Psychiatry and King's College Hospital, de Crespigny Park, London SE5 8AF, UK

Robin M. Murray

Institute of Psychiatry and King's College Hospital, de Crespigny Park, London SE5 8AF, UK

This paper summarizes the methodological aspects and findings of a long-term study involving 89 depressed patients who were admitted to the Royal Maudsley Hospital between 1965 and 1966, and who were followed- up 18 years later. Less than 20% of the survivors had remained well and > 33% of the series suffered unnatural death or severe chronic distress and handicap. Patients whose index episode marked their first psychiatric contact had a 50% chance of readmission within their lifetime, but those with previous admissions had a 50% chance of readmission within 3 years. High neuroticism scores on the Eysenck Personality Inventory on recovery, and when ill but referring to the pre-morbid state, were associated with poor overall outcome and chronicity. High obsessional interference scores on the Leyton Obsessional Inventory on recovery were also associated with poor long-term outcome, impaired social adjustment, more time spent in hospital and with the subsequent development of schizophrenic or schizoaffective episodes. Subtyping according to the Research Diagnostic Criteria, DSM-III, Newcastle Index and PSE/Catego criteria had little prognostic utility. However, DSM-III melancholia was shown to have an interactive effect with the personality measure neuroticism such that melancholic individuals, who at index had high neuroticism scores, were very likely to have a poor outcome.

Key Words: depression • psychosis • neurosis • personality • outcome • suicide

Journal of Psychopharmacology, Vol. 6, No. 2 suppl, 300-303 (1992)
DOI: 10.1177/0269881192006002031


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