Spontaneous remission refers to the achievement of subclinical levels of physical or psychological symptoms of a specific condition without the aid of psychological, medical, or pharmacological treatment. In depression, spontaneous remission has been the topic of recent research, with an emphasis on the role and necessity of treatment. Some research has suggested that intervention is not necessary to achieve remission in all cases, while other research has underscored the importance of mental health treatment for depression.
To explore this issue further, Harvey A. Whiteford of the Policy and Evaluation Group at the Queensland Centre for Mental Health Research in Australia recently conducted an analysis on 19 existing studies to determine the rate of spontaneous remission in untreated major depression. Whiteford found looked at adults, children, and elderly individuals with depression that were waitlisted or who served as controls in clinical studies. He evaluated remission based on symptom severity over a one year period.
The results revealed that 23% of adults will experience remission of depression without treatment in three months, 32% in six months and 53% in a year. Whiteford found that children and adolescents were more likely to achieve remission without treatment than adults. They also achieved remission sooner than adults did during the 12-month period.
When symptom severity was examined, it was revealed that individuals with severe symptoms were 25% less likely to remit than those with only mild symptoms of depression. Factors that affect symptom severity, along with personal treatment preferences and barriers to treatment, could also affect remission and choice to treat. Although not explored in this study, these factors should be examined in future work.
The findings presented here provide new direction for clinicians working with depressed clients. The results support a wait and see approach for treating some cases of depression, and in particular, cases with mild and moderate symptoms. Doing so could make critical resources more available to high risk clients.
Whiteford added, “Resources should be directed towards those with greatest need, for example those experiencing more severe depression and those whose symptoms are likely to persist or reoccur.” These findings are novel and because this research is a relatively new avenue of exploration, these results should be further validated before suggestions are fully implemented in clinical settings.
Whiteford, H. A., et al. (2013). Estimating remission from untreated major depression: A systematic review and meta-analysis. Psychological Medicine 43.8 (2013): 1569-85. ProQuest. Web.
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