Does treatment influence mortality in depressives? A follow-up of 1076 patients with major affective disorders
This article reports mortality risk among 1076 Iowans with major affective disorders (705 primary unipolar, 219 secondary unipolar, and 152 bipolar depressives) compared to that of the general population. Patients were divided into four treatment groups depending on primary mode of therapy during the index admission; the groups included electroconvulsive therapy (ECT), adequate antidepressants, inadequate antidepressants, and neither treatment. All patients in the sample had an increased risk for an early death. A high risk for suicide was found for patients within each individual treatment group during the follow-up, especially the first 2 years when 69.4% (n = 25) of total suicides occurred. There were no significant differences in the risk for suicides, or deaths from all causes combined, among patients in the four treatment groups. Furthermore, mortality did not differ between patients having a lifetime history of ECT and patients never having had ECT. We conclude from a short-term follow-up of depressives that mode of therapy received in the hospital has minimal influence on subsequent mortality, including suicide.
Black, DW; Winokur, G; Mohandoss, E; Woolson, RF; Nasrallah, A
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