Subtypes of Depressive Episodes According to ICD-10: Prediction of Risk of Relapse and SuicideKessing L.V.
Department of Psychiatry, University of Copenhagen, Rigshospitalet, Copenhagen, and Department of Psychiatric Demography, University of Aarhus, Psychiatric Hospital, Risskov, Denmark
Background: The long-term predictive ability of the ICD-10 subtypes of depression with melancholic syndrome and depression with psychosis has not been investigated. Sampling and Methods: All patients in Denmark who had a diagnosis of a single depressive episode at their first ever discharge during a period from 1994 to 1999 were identified. The risk of relapse leading to readmission and the risk of committing suicide were compared for patients discharged with an ICD-10 diagnosis of a single depressive episode with and without melancholic syndrome and for patients with and without psychotic symptoms, respectively. Results: In all, 1,639 patients had a diagnosis of depressive episode without psychotic symptoms, 1,275 patients a diagnosis with psychotic symptoms, 293 a diagnosis without melancholic syndrome, and 248 a diagnosis with melancholic symptoms at first discharge. The risk of relapse leading to readmission was greater for patients with psychotic symptoms than for patients without, but no difference was found between the two groups in the risk of committing suicide during follow-up. No differences were found in the risk of relapse leading to readmission or suicide between patients with and without melancholic syndrome. Conclusions: The ICD-10 categorization into depression with and without psychotic symptoms seems to be clinically and prognostically useful, whereas the ICD-10 subtyping into melancholic and non-melancholic syndrome does not seem to have any long-term predictive value.
Lars Vedel Kessing
Department of Psychiatry, University Hospital of Copenhagen
Rigshospitalet, Blegdamsvej 9
DK–2100 Copenhagen Ø (Denmark)
Tel. +45 3545 6237, Fax +45 3545 6218, E-Mail firstname.lastname@example.org
Received: April 4, 2003
Accepted after revision: August 8, 2003
Published online: November 27, 2003
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 3, Number of References : 22
Psychopathology (International Journal of Descriptive and Experimental Psychopathology, Phenomenology and Psychiatric Diagnosis)
Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’
Official Journal of the World Psychiatric Association (WPA), Section of Clinical Psychopathology and Section of Classification and Diagnostic Assessment
Vol. 36, No. 6, Year 2003 (Cover Date: November-December 2003)
Journal Editor: C. Mundt, Heidelberg; E. Gabriel, Vienna; J.E. Mezzich, New York, N.Y.
ISSN: 0254–4962 (print), 1423–033X (Online)
For additional information: http://www.karger.com/psp