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Fast versus slow onset of depressive episodes: A clinical criterion for subtyping patients with major depression

Published online by Cambridge University Press:  15 April 2020

U. Hegerl ,
R. Mergl ,
D. Quail ,
E. Schneider ,
M. Strauß ,
H.-P. Hundemer  and
M. Linden
U. Hegerl*
Affiliation:
Department of Psychiatry, University of Leipzig, Semmelweisstr. 10, 04103Leipzig, Germany
R. Mergl
Affiliation:
Department of Psychiatry, University of Leipzig, Semmelweisstr. 10, 04103Leipzig, Germany
D. Quail
Affiliation:
Lilly UK, Department European Medical Information Sciences, Windlesham, Surrey GU20 6PH, United Kingdom
E. Schneider
Affiliation:
Lilly Germany, Medical Department, Division of Neuroscience, Werner-Reimers-Str. 2-4, 61352Bad Homburg, Germany
M. Strauß
Affiliation:
Department of Psychiatry, University of Leipzig, Semmelweisstr. 10, 04103Leipzig, Germany
H.-P. Hundemer
Affiliation:
Lilly Germany, Medical Department, Division of Neuroscience, Werner-Reimers-Str. 2-4, 61352Bad Homburg, Germany
M. Linden
Affiliation:
Research Group Psychosomatic Rehabilitation at the Charité, University Medicine Berlin and the Rehabilitation Centre Seehof, Lichterfelder Allee 55, 14513Teltow/Berlin, Germany
*
*Corresponding author. Tel.: +49 341 9724 530; fax: +49 341 9724 539. E-mail address:[email protected] (U. Hegerl).
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Abstract

Purpose:

The speed of onset of depressive episodes is a clinical aspect of affective disorders that has not been sufficiently investigated. Thus, we aimed to explore whether patients with fast onset of the full-blown depressive symptomatology (≤ 7 days) differ from those with slow onset (> 7 days) with regard to demographic and clinical aspects.

Subjects and methods:

Data were obtained within an observational study conducted in outpatients with major depression who were treated with duloxetine (30–120 mg/day). Onset of depression (without any preceding critical life event) was fast in 416 (less than one week) and slower in 2220 patients.

Results:

Compared to patients with slow onset, those with fast onset of depression had more suicide attempts in the previous 12 months (2.7% versus 1.3%, P = 0.046) and less somatic comorbidity (61.7% versus 74.1%, P < 0.0001). In addition, they were slightly younger at onset of depression (mean ± SD 40.2 ± 14.6 versus 42.8 ± 14.2 years, P < 0.001) and used analgesics at baseline significantly less frequently (22.8% versus 33.4%, P < 0.0001).

Discussion and conclusion:

The speed of onset of depression has to be regarded as a relevant clinical characteristic in patients with unipolar depression.

Keywords

DepressionMood disordersSpeed of onsetMulti-centre trial
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 5 , June 2013 , pp. 288 - 292
Copyright
Copyright © European Psychiatric Association

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