English summary: DEPRESSION WILL IMPROVE - FINDINGS FROM A SIX-YEAR FOLLOW-UP STUDY

Background. Among mental disorders major depression and other depressive disorders are the most common causes of sickness benefits and pensions due to incapacity for work. Nevertheless, there are only a few long-term studies on outcome and capacity for work among patients with depression.

Methods. We followed up 121 patients with major depressive disorder for six years, on average. Somatic comorbidity (68%) and personality disorders (42%) were common. The 17-item Hamilton Depression Rating Scale (HDRS) was used to assess the severity of depression.

Results. Most patients (84 %) had recovered (HDRS score <= 11) at the end of follow-up. Recovery from depression was fastest during the first months. At the end of follow-up only one fifth (20%) of the patients had any adjunct therapeutic relationship and less than half of them (41%) were on antidepressants at adequate doses. The proportion of those who were pensioned due to incapacity for work increased from 13% to 55% during the follow-up. Those who were incapable of work were more depressed. Age and somatic comorbidity were significantly associated with incapacity for work.

Conclusions. These findings suggest that symptoms of depression are alleviated in the course of time. Effective medical interventions are important especially during the first months of treatment but continuous therapy and rehabilitation must not be forgotten. It is possible that pensions due to incapacity for work could be at least delayed if patients with depression were treated more vigorously.