Acta Psychiatrica Scandinavica最新文献

{"title":"A Systematic Review and Meta-Analysis of the Association Between Childhood Maltreatment and Adult Depression","authors":"Christopher B. Watson,&nbsp;Christopher F. Sharpley,&nbsp;Vicki Bitsika,&nbsp;Ian Evans,&nbsp;Kirstan Vessey","doi":"10.1111/acps.13794","DOIUrl":"10.1111/acps.13794","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childhood maltreatment (CM) and depression are serious global issues with high prevalence and lifelong impacts on physical and mental health. CM has been proposed as a modifiable risk factor for depression that, if prevented, may contribute to a reduction in the global incidence of depressive disorders. Despite this, there is a paucity of reviews examining the strength of the association between these variables. The aim of this systematic review and meta-analysis was to evaluate the empirical evidence and determine if CM is supported as a preventable risk factor for depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search was performed in July 2024 for all peer-reviewed journal articles written in English examining the relationship between CM and adult depression in the electronic databases <i>EBSCOhost</i>, <i>Proquest</i>, and <i>Embase</i>. Studies were included in this review if they measured maltreatment before 18 years of age as the independent variable and adult depression as the dependent variable. Studies were excluded if the outcome variable was grouped with comorbidity and if they did not report primary quantitative data. A total of 77 studies with 516,302 participants met the inclusion criteria for review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A random-effects meta-analysis was used to generate a pooled odds ratio from 87 effect estimates and demonstrated that individuals with a history of any CM are 2.5 times more likely to experience adult depression (<i>OR</i> = 2.49 [95% CI: 2.25–2.76]). This increase in odds remained regardless of how the primary studies screened for depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings confirmed the strong association between the experience of CM and adult depression. High heterogeneity in the meta-analytic results also suggested that further research is required that applies consistent adjustments for comorbidities and confounding factors and examines the temporal relationship between the variables to establish causality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 5","pages":"572-599"},"PeriodicalIF":5.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Risk Predicts White Matter Hyperintensities, Brain Atrophy and Treatment Resistance in Major Depressive Disorder: Role of Genetic Liability","authors":"Marco Paolini,&nbsp;Melania Maccario,&nbsp;Virginia Saredi,&nbsp;Anna Verri,&nbsp;Federico Calesella,&nbsp;Laura Raffaelli,&nbsp;Cristina Lorenzi,&nbsp;Sara Spadini,&nbsp;Raffaella Zanardi,&nbsp;Cristina Colombo,&nbsp;Sara Poletti,&nbsp;Francesco Benedetti","doi":"10.1111/acps.13793","DOIUrl":"10.1111/acps.13793","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Depressive disorders are a leading cause of global disease burden, particularly with the challenge of treatment-resistant depression (TRD). Research points to a complex bidirectional relationship between cardiovascular (CV) risk factors and TRD, with CV risk negatively impacting brain structure and potentially influencing antidepressant resistance. Moreover, the association between depression and the genetic vulnerability to cardiovascular disease suggests a shared pathophysiological process between the two. This study investigates the mediating role of brain structural alterations in the relationship between CV and cerebrovascular (CeV) risk and treatment resistance in depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed 165 inpatients with Major depressive disorder. Each patient's CV risk was assessed via the QRISK 3 calculator. For a subset of patients, CV and CeV disease polygenic risk scores (PRS) were obtained. All patients underwent a 3 T MRI scan, and white matter hyperintensities estimates and indicators of brain trophic state were obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both CV risk and CV disease PRSs are associated with treatment resistance status, white matter hyperintensities, and indicators of brain atrophy. Mediation analyses suggested that CV-induced brain alterations might underlie the relation between CV genetic and phenotypic risk and antidepressant treatment resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results underscore the need to explore cardiovascular risk management as part of treatment strategies for depression, pointing toward a shared pathophysiological process linking heart and brain health in treatment-resistant depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 6","pages":"709-718"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiation and Discontinuation of Psychotropic Drugs Relative to Suicidal Behavior: A Danish Registry-Based Study","authors":"Mette Reilev,&nbsp;Jacob Harbo Andersen,&nbsp;Mikkel Højlund,&nbsp;Elsebeth Stenager,&nbsp;Lotte Rasmussen,&nbsp;Erik Christiansen","doi":"10.1111/acps.13792","DOIUrl":"10.1111/acps.13792","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Changes in psychotropic drug use relative to suicidal behavior could potentially inform the timing of preventive efforts. We aimed to describe the initiation and discontinuation of psychotropic drugs relative to suicide and suicide attempts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Danish registries were used to describe incidents and prevalent use of psychotropic drugs 2 years before and after a suicide attempt and before suicide. Discontinuation of psychotropic drugs in the 6-month period prior to suicide and suicide attempts was estimated. Analyses were stratified by drug groups, sex, and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5.8 million Danish citizens(2021), 6374 died by suicide, and 29,332 had a first-ever suicide attempt from 2010 to 2021. Use of psychotropic drugs increased markedly in the 6 months prior to suicide and suicide attempt, e.g., up to 18 incident drug redemptions and 92 prevalent drug redemptions per 100 persons in the month before suicide. The highest rates of both incident and prevalent drug redemptions were observed immediately after the suicide attempt. Psychotropic drug use was generally lower among men. Immediately after the suicide attempt, however, men exhibited a slightly higher level of incident use than women. Ten percent discontinued psychotropic drugs completely in the 6-month period before suicide, while 48% discontinued drugs used in alcohol abuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found a marked increase in psychotropic drug use before suicide and before and after attempted suicide. Complete pre-attempt discontinuation of psychotropic drugs was low, though approximately half discontinued drugs used for alcohol abuse. The process of prescribing psychotropic drugs may represent an opportunity for prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 6","pages":"698-708"},"PeriodicalIF":5.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation Between Brain Morphological Features and Psychiatric Hospitalization Risk in Major Depressive and Bipolar Disorders","authors":"Kamilla W. Miskowiak,&nbsp;Julian Macoveanu,&nbsp;Brice Ozenne,&nbsp;Emily E. Beaman,&nbsp;Vibeke H. Dam,&nbsp;Patrick M. Fisher,&nbsp;Gitte M. Knudsen,&nbsp;Lars V. Kessing,&nbsp;Martin B. Jørgensen,&nbsp;Vibe G. Frokjaer,&nbsp;Anjali Sankar","doi":"10.1111/acps.13790","DOIUrl":"10.1111/acps.13790","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with mood disorders, especially, major depressive disorder (MDD) and bipolar disorder (BD), are at heightened risk of relapse and psychiatric rehospitalizations. Therefore, there is an urgent need to identify modifiable biomarkers to inform personalized and intensified prevention strategies for those at the greatest risk of relapse and hospital readmissions. Brain structural measures subserving cognitive function hold particular promise among potential predictive biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the present study, structural magnetic resonance imaging scans were obtained from 319 patients with BD (<i>n</i> = 241) or MDD (<i>n</i> = 78). [Correction added on 7 March 2025, after first online publication: In the preceding sentence, ‘MDD (n=241) or BD (n=78)’ has been changed to ‘BD (n=241) or MDD (n=78)’.] Longitudinal data on psychiatric hospitalization for up to 10 years were available from the Danish National population-based registers. Interhemispheric hippocampal asymmetry, a putative marker of cognitive function and brain reserve, was calculated for each patient. The association between hippocampal asymmetry and future psychiatric hospitalization was assessed using a cause-specific Cox regression model. Exploratory analyses, also using a cause-specific Cox model, assessed the association of prefrontal and hippocampal gray matter volume and whole-brain white matter volume with hospitalizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated a negative association between rightward hippocampal asymmetry (i.e., left&lt;right) and risk of future hospitalizations (HR = 0.90, corresponding to a 10-year risk reduction of 0.018 for a 1% increase in asymmetry, <i>p</i> = 0.040). Exploratory analysis indicated that a larger right hippocampus volume was associated with a reduced risk of hospitalization (HR = 0.18, <i>p</i> = 0.004) while a larger bilateral dorsolateral prefrontal volume (HR = 1.06, <i>p</i> = 0.01) was associated with an increased risk of hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest a role for hippocampal and, additionally, prefrontal morphological features in the risk of future psychiatric hospitalizations in mood disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 6","pages":"689-697"},"PeriodicalIF":5.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13790","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Receiving Information on Machine Learning-Based Clinical Decision Support Systems in Psychiatric Services Increases Staff Trust in These Systems: A Randomized Survey Experiment","authors":"Erik Perfalk,&nbsp;Martin Bernstorff,&nbsp;Andreas Aalkjær Danielsen,&nbsp;Søren Dinesen Østergaard","doi":"10.1111/acps.13791","DOIUrl":"10.1111/acps.13791","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical decision support systems based on machine learning (ML) models are emerging within psychiatry. To ensure their successful implementation, healthcare staff needs to trust these systems. Here, we investigated if providing staff with basic information about ML-based clinical decision support systems enhances their trust in them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a randomised survey experiment among staff in the Psychiatric Services of the Central Denmark Region. The participants were allocated to one of three arms, receiving different types of information: An intervention arm (receiving information on clinical decision-making supported by an ML model); an active control arm (receiving information on standard clinical decision process without ML support); and a blank control arm (no information). Subsequently, participants responded to various questions regarding their trust/distrust in ML-based clinical decision support systems. The effect of the intervention was assessed by pairwise comparisons between all randomization arms on sum scores of trust and distrust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2838 invitees, 780 completed the survey experiment. The intervention enhanced trust and diminished distrust in ML-based clinical decision support systems compared with the active control arm (Trust: mean difference = 5% [95% confidence interval (CI): 2%; 9%], <i>p</i> value &lt; 0.001; Distrust: mean difference = −4% [−7%; −1%], <i>p</i> value = 0.042) and the blank control arm (Trust: mean difference = 5% [2%; 11%], <i>p</i> value = 0.003; Distrust: mean difference = −3% [−6%; −1%], <i>p</i> value = 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Providing information on ML-based clinical decision support systems in hospital psychiatry may increase healthcare staff trust in such systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"152 1","pages":"39-48"},"PeriodicalIF":5.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Recovery and Recurrence From Major Depression in Adolescence and Adulthood”","authors":"Amogh Verma,&nbsp;Shubham Kumar,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1111/acps.13789","DOIUrl":"10.1111/acps.13789","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 5","pages":"646-648"},"PeriodicalIF":5.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Is a Vegetarian Diet Beneficial for Bipolar Disorder? Relationship Between Dietary Patterns, Exercise and Pharmacological Treatments With Metabolic Syndrome and Course of Disease in Bipolar Disorder”","authors":"","doi":"10.1111/acps.13788","DOIUrl":"10.1111/acps.13788","url":null,"abstract":"<p>S. Gomes-da-Costa, I. Fernandéz-Pérez, R. Borras, et al., “Is a Vegetarian Diet Beneficial for Bipolar Disorder? Relationship Between Dietary Patterns, Exercise and Pharmacological Treatments With Metabolic Syndrome and Course of Disease in Bipolar Disorder,” <i>Acta Psychiatrica Scandinavica</i> 150, no. 4 (2024): 209–222.</p><p>The correct ones are highlighted in the following table, the values in yellow in the article's table refer to the <i>p</i>-value, of each value with statistical significance *.</p><p>The correct ones are highlighted in the following table, the values in yellow in the article's table refer to the <i>p</i>-value, of each value with statistical significance *.</p><p>The correct ones are highlighted in the following table, the values in yellow in the article's table refer to the <i>p</i>-value, of each value with statistical significance *.</p><p>We apologize for this error.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"550-553"},"PeriodicalIF":5.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13788","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: “Means Restriction for Suicide Prevention: An Umbrella Review”","authors":"Nosaibah Razaqi,&nbsp;Rachana Mehta,&nbsp;Shubham Kumar,&nbsp;Ranjana Sah","doi":"10.1111/acps.13787","DOIUrl":"10.1111/acps.13787","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 6","pages":"731-732"},"PeriodicalIF":5.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142996412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Functional Connectivity of Prefrontal Cortex-Related Circuitry and Trait Impulsivity in Patients With Bipolar Disorder and History of Suicide Attempts","authors":"Mao-Hsuan Huang,&nbsp;Yi-Hsuan Kuan,&nbsp;Pei-Chi Tu,&nbsp;Wan-Chen Chang,&nbsp;Yee-Lam E. Chan,&nbsp;Tung-Ping Su","doi":"10.1111/acps.13786","DOIUrl":"10.1111/acps.13786","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The neurobiological basis of impulsivity and its role in suicide attempt (SA) in BD remains underexplored. This study aimed to examine the functional connectivity (FC) within the prefrontal cortex (PFC) in BD patients with and without a history of SA, focusing on the role of trait impulsivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-two euthymic BD patients (34 with a history of SA, BDSA; and 38 without, BDNS) and 55 age- and sex-matched healthy controls underwent resting-state functional MRI. FC analyses were conducted on four PFC regions: superior frontal gyrus (SFG), middle frontal gyrus (MFG), inferior frontal gyrus (IFG), and orbitofrontal cortex (OFC). Trait impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11), and its association with FC was analyzed using a general linear model, adjusting for demographic and clinical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BDSA had higher trait impulsivity than BDNS and the controls. BDSA exhibited reduced FC between the PFC and sensorimotor (postcentral and precentral gyri) and thalamic regions compared to BDNS. These reductions in FC of the fronto-thalamic and fronto-sensorimotor circuits were significantly associated with higher trait impulsivity scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings highlight specific PFC-based FC alterations associated with suicide attempts and trait impulsivity in BD, offering potential neurobiological markers for suicide risk in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 5","pages":"634-643"},"PeriodicalIF":5.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery and Recurrence From Major Depression in Adolescence and Adulthood","authors":"Adrian E. Desai Boström,&nbsp;Thomas Cars,&nbsp;Clara Hellner,&nbsp;Johan Lundberg","doi":"10.1111/acps.13785","DOIUrl":"10.1111/acps.13785","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to estimate 5-year recurrence rates of first-episode major depressive disorder (MDD) and assess the impact of adolescence on recurrence likelihood after the first episode, compared to adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pre-registered retrospective cohort study that utilized epidemiological data from the Stockholm MDD Cohort (1997–2018), including all individuals registered with a depression diagnosis in Region Stockholm from 2010 to 2018. This dataset combines longitudinal information from primary and secondary care, socioeconomic data, drug dispensations, psychotherapy sessions, brain stimulation treatments, and inpatient treatment. The study included 9124 individuals (1727 adolescents aged 13–17 and 7397 adults aged 18–40) who experienced their first MDD episode between 2011 and 2012, with at least three months of remission. Propensity score weighting balanced cohorts for biological sex, socioeconomic status, depression severity, psychiatric comorbidities, and treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 5-year recurrence rates were 46.1% for adolescents and 49.0% for adults. The study had over 80% power to detect a minimum absolute difference in recurrence rates of approximately 5.5 percentage points. No significant difference in recurrence likelihood (<i>p</i> = 0.364) or time from remission to recurrence (median 379 days for adolescents, 326 days for adults, <i>p</i> = 0.836) was found between groups. Findings were consistent across bootstrap replicates and sensitivity analyses with extended remission periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Approximately half of individuals with a first MDD episode experience recurrence within five years. Recurrence rates were higher than expected for adults but consistent with expectations for adolescents. The study underscores the need for relapse prevention from adolescence through adulthood and indicates a similar clinical course of MDD across age groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 5","pages":"625-633"},"PeriodicalIF":5.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}