Depressive Disorder

Prognosis of Depressive Disorder

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The prognosis of the illness is usually very much associated with the presence of triggering factors. When the depressive disorder appears totally spontaneously, the prognosis is usually better. On the other hand, when it is associated with some precipitating event or with personality traits of the patient, it usually has a tendency towards becoming chronic (or put another way, a poor response to the treatment).

Acute complications of depressive disorder

The main acute complication to highlight is suicide (or attempted suicide):

  • People that suffer from a depressive disorder have a suicide risk of 30 times more than the general population.
  • Approximately 15% of patients that suffer from a depressive disorder make at least one suicide attempt.

The existence of any of these factors and, in particular, the combination of several of them, must be seen as a warning of the possibility that a suicide attempt may be made:

  • Feeling of deep despair.
  • Elevated anxiety.
  • Recurrent ideas of suicide.
  • Very impulsive or very self-demanding personality. Impulsiveness is particularly associated with an increased risk of a suicide attempt; self-demandingness is mainly associated with a higher risk of accomplished suicide.
  • Subjective or objective feeling of loneliness (for example, widowhood).
  • Abuse of alcohol or other drugs.
  • Co-existence of another serious illness.
  • Physical and/or sexual abuse in infancy.
  • Previous suicide attempt.
  • Family history of suicide or attempted suicide.

Ideas of suicide are one more symptom of the illness.

Chronic complications of depressive disorder

The main long-term complication of depressive disorders, particularly in the dysthymia subtypes and major depression, is the increased tendency for relapses.

It is not possible to predict who will have them in a recurrent course and who will not. However, there are certain variables that are associated with a higher or lower tendency to present with new episodes.

  • Presence of residual symptoms (symptoms not completely cured).
  • The age of the individual at the time of having the last episode. The older the person, a greater tendency to relapse.
  • The number of previous episodes.
  • The intensity of the dysfunctional personality traits.

It must be remembered that depressive disorders can have a trigger (for example, a stressful environmental situation), or can apparently be spontaneous. Therefore, it is important to highlight that it is very characteristic of the depressive disorders that the greater the number of previous episodes the more autonomy of the disorder; that is to say, the more previous episodes, it is more probable that the next episode may not have an external trigger.

Substantiated information by:

Joana Guarch Domènech
Víctor Navarro

Published: 3 April 2018
Updated: 3 April 2018

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