There are numerous classifications of depression, including dysthymic disorder (Dysth), major depressive disorder (MDD), and double depression (DD), which represents the presence of both Dysth and MDD. Identifying these classes individually is challenging because often there is an overlap in symptoms and varying degrees of severity. Some types of depression remit and others are chronic conditions. The DSM-IV currently has several different categories of depression that influence treatment approaches and outcome. However, it is imperative that these categories be properly assessed for accuracy and illness trajectory in order to ensure that individual clients are receiving the proper care for their unique classification of depression. To do this, D. Rhebergen of the Department of Psychiatry and the EMGO Institute for Health and Care Research at the University Medical Center Amsterdam in the Netherlands recently led a study that examined trajectory and symptomology in 804 individuals diagnosed with unipolar depression.
Rhebergen analyzed the data from the Netherlands Study of Depression and Anxiety (NESDA) and found that five specific trajectories existed among MDD, Dysth, and DD. The trajectories ranged from swift remission to extreme and chronic symptom severity. Over half of the participants diagnosed with DD and Dysth had favorable outcomes. In addition, the youngest female participants with the fewest psychological and social barriers were the most likely to have positive course trajectories, while the participants with the earliest onset age and highest levels of introversion had the poorest trajectories. In this study, just over 40% of the participants had swift remission, and only 20% had chronic and severe trajectories. These findings suggest that the current categories outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), do not accurately represent the existing varying degrees of depression. “To conclude, MDD, Dysth, and DD did not adequately match empirically derived course trajectories for unipolar depression,” said Rhebergen. Clinical interventions could be improved if they included assessments of both depression symptoms and trajectory.
Rhebergen, D., Lamers, F., Spijker, J., De Graaf, R., Beekman, A. T. F. (2012). Course trajectories of unipolar depressive disorders identified by latent class growth analysis. Psychological Medicine, 42.7, 1383-1396.
© Copyright 2012 GoodTherapy.org. All rights reserved.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.