Predicting Depression Recurrence

Depression Recurrence PredictionFor people with a history of unipolar depression (episodes in the past of clinically significant depression, but no history of periods of being energized – mania or hypomania) who are no longer experiencing a clinical depression, is it possible to predict whether they will have another episode in the near future?

Noted psychiatric researchers Lewis L. Judd, MD, Pamela J. Schettler, PhD, and John Rush, MD just published a study designed to see if certain symptoms on a common psychiatric symptom checklist (the Symptom Checklist–90 or SCL-90) could be used to predict the risk of a recurrence.

They found that about 12 of the 90 symptoms predicted a recurrence.

In order of predictive value, the symptoms were –

  1. Feeling blocked in getting things done
  2. Feeling pushed to get things done
  3. Feeling tense or keyed up
  4. Having ideas/beliefs others do not share
  5. Feeling inferior to others
  6. Feeling low in energy or slowed down
  7. Feeling very self-conscious with others
  8. Headaches
  9. Crying easily
  10. Feelings being easily hurt
  11. Worrying too much about things
  12. Trouble concentrating

Interestingly, some of the symptoms that would seem to be more central to depression (feeling no interest in things, feeling blue and feeling lonely) did not predict depression as well as symptoms that are less specific to depression.

For a quick self-quiz… add up how many of these symptoms describe how you have been feeling in the past week.

If you check none of these you have a 95% chance of not experiencing a clinically significant depression in the next six months.

If you check one to five of these your risk of having a clinically significant depression is about 15%.

If you check six to nine of the symptoms your risk is about 30%, and if you check ten or more symptoms your risk is almost 75%.

Now, what to do about this information?

If you are at increased risk you might do one of these things –

  1. Talk to your psychiatrist or health care provider about medications that might prevent depression.
  2. Talk to your psychologist or therapist about increasing the frequency of therapy sessions.
  3. Use self help strategies for reducing depression risk.

References

A Brief Clinical Tool to Estimate Individual Patients’ Risk of Depressive Relapse Following Remission: Proof of Concept Lewis L. Judd, Pamela J. Schettler, and A. John Rush American Journal of Psychiatry (published online July 2016)