ABSTRACT
Dysthymic disorder (DD) is defined and distinguished from major depressive disorder (MDD) largely on the basis of its course. Surprisingly, however, there have been few prospective, longitudinal studies of the naturalistic course of DD. This article reports the major findings from a prospective, longitudinal 30-month follow-up study of 86 outpatients with early-onset DD (EOD) and 39 outpatients with episodic MDD. Follow-up assessments included the Longitudinal Interval Follow-Up Evaluation and Hamilton Rating Scale for Depression. Compared with patients with episodic MDD, patients with EOD exhibited less improvement from the baseline evaluation and were more symptomatic at follow-up. Only 39% of patients with EOD recovered from DD during the follow-up period. The diagnosis of DD was fairly stable, with 52% of the EOD group meeting full criteria for DD at follow-up. These data provide prospective confirmation of the chronic course of DD.
Subject(s)
Dysthymic Disorder/diagnosis , Adolescent , Adult , Chronic Disease , Comorbidity , Depressive Disorder, Major/classification , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychology , Diagnosis, Differential , Dysthymic Disorder/classification , Dysthymic Disorder/psychology , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Prognosis , Prospective Studies , Psychiatric Status Rating ScalesABSTRACT
Potential subject participation biases in a family study of outpatients with mood disorders and personality disorders (PDs) were explored at three levels: (1) differences between probands who granted permission to contact all relatives, those who gave permission to contact only a subset of relatives, and those who denied permission to contact any relatives; (2) differences between relatives whom the proband granted permission to contact and those whom the proband denied permission to contact; and (3) for the relatives who could be contacted, differences between those who agreed to participate and those who declined. Subjects included 156 outpatients with mood disorders and PDs and 611 of their first-degree relatives. Axis I and II disorders in probands and relatives were evaluated using structured diagnostic interviews. In addition, informant reports on relatives were obtained from family history (FH) interviews. Results indicated that probands who gave and who withheld consent to contact their relatives did not differ significantly on most variables. However, relatives whom we were not permitted to contact were significantly more likely to have drug abuse and PDs. Finally, of the relatives we were permitted to contact, there were few differences between those who participated in the study and those who refused to participate. These findings indicate that the greatest risk of sampling bias in family studies stems from probands' reluctance to grant access to relatives with drug abuse and PDs.
Subject(s)
Mood Disorders/genetics , Personality Disorders/genetics , Adult , Alcoholism/genetics , Alcoholism/psychology , Bias , Female , Humans , Male , Middle Aged , Models, Genetic , Mood Disorders/psychology , Personality Assessment/statistics & numerical data , Personality Disorders/psychology , Psychometrics , Substance-Related Disorders/genetics , Substance-Related Disorders/psychologySubject(s)
Anticoagulants/therapeutic use , Arteriosclerosis Obliterans/drug therapy , Thrombosis/prevention & control , Arteriosclerosis Obliterans/mortality , Cerebral Infarction/prevention & control , Clinical Trials as Topic , Follow-Up Studies , Humans , Myocardial Infarction/prevention & controlABSTRACT
The clinical efficacy of antithrombolytic drugs in different combinations was studied on a large contingent of patients with cerebral, coronary atherosclerosis and obliterating atherosclerosis of the vessels. It was shown that regular administration of acetylsalicylic acid with coumarin derivatives prolongs life of patients with cardiovascular diseases and decreases the number of vascular catastrophes.
