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The median time interval between primary diagnosis and FDG PET-CT examination was 52 months (range 3 217 months); 33 patients (73.3 %) experienced at least one or more previous episodes of local or loco-regional recurrence in this intervening period.
Cases when outcome is poor are associated with inappropriate treatment, severe initial symptoms that may include psychosis, early age of onset, more previous episodes, incomplete recovery after 1 year, pre-existing severe mental or medical disorder, and family dysfunction as well.
In the guideline maintenance pharmacotherapy is indicated in all patients with three or more previous episodes.
We made a post hoc decision to repeat the t-tests excluding participants with a history of only one episode, thus comparing the never depressed participants to participants that had two or more previous episodes of depression (n = 51).
Kenny and Williams [ 21] reported a decrease in depressive symptoms in a sample of currently depressed patients who experienced symptoms for one year or longer, preceded by three or more previous episodes.
Participants must be 18 years or older, and have a Hamilton-Depression Rating Scale (HAM-D) 36 score of at least 15, a current diagnosis of major depressive disorder in the Structured Clinical Interview for DSM-IV Axis I (SCID-I), 37 and either TRD defined as two or more previous episodes of depression or chronic depression.
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Worse treatment response in patients with more previous mixed episodes, delusions during manic episodes, and appetite increase during depressive episodes was observed not only in the main analysis of all subjects but also in the supplementary analysis of BD-I patients alone.
The responders had more respiratory symptoms (χ21 = 19.21, P <.001), fulfilling the criteria for respiratory PD subtype (80.6%); the disorder started earlier (Mann-Whitney, P <.001), had a higher familial prevalence of PD (χ21 = 20.45, P =.028), and had more previous depressive episodes (χ21 = 27.98, P <.001).
Swann et al. (2009a) found those with more previous mood episodes have higher BIS total scores.
Sixteen of the subjects diagnosed with bipolar disorder reported one or more previous psychotic episodes.
According to the multivariate analysis in our study, patients with more previous depressive episodes and/or psychotic symptoms were more likely to receive augmentation therapy.
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