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Am J Psychiatry 1991; 148:345-350
Copyright © 1991 by American Psychiatric Association
12-month outcome of patients with major depression and comorbid psychiatric or medical illness (compound depression)
GI Keitner, CE Ryan, IW Miller, R Kohn and NB Epstein
Department of Psychiatry and Human Behavior, Brown University, Providence, RI.
OBJECTIVE: Inpatients with major depressive illness often have coexistent
nonaffective psychiatric and/or medical conditions. The authors' objective
is to address the following questions: 1) What is the effect of comorbid
illness on the severity of major depression and associated psychosocial
factors? 2) How does the course of depression differ for patients with and
without concurrent illness? 3) Do patients with compound depression differ
in rate of recovery and time to recovery from patients with pure
depression? METHOD: The subjects were 78 patients with a DSM-III diagnosis
of major depression who were consecutively admitted to an acute care
university-affiliated psychiatric hospital; 37 of these patients had major
depression only and 41 had major depression compounded by a coexisting axis
I, II, or III condition. The patients were studied while hospitalized and
for 12 months after hospital discharge. Instruments used included the
Modified Hamilton Rating Scale for Depression, the Global Assessment Scale,
and the Social Readjustment Rating Scale. RESULTS: Patients with compound
depression reported significantly poorer functioning over the 12-month
follow-up period and had lower recovery rates than the patients with pure
depression. There were no differences in recovery rates between men and
women with compound depression, but significantly more men than women with
pure depression recovered. CONCLUSIONS: Compound depression is a common
clinical occurrence, the course of illness is more difficult for patients
with compound depression than for patients with pure depression, and the
recovery rate of patients with compound depression is lower than that of
patients with pure depression.
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