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Hardeveld F.,Institute for Mental Health Care | Hardeveld F.,Netherlands Institute of Mental Health and Addition | Spijker J.,Institute for Mental Health Care | Spijker J.,Netherlands Institute of Mental Health and Addition | And 3 more authors.
Acta Psychiatrica Scandinavica | Year: 2010

Objective: Knowledge of the risk of recurrence after recovery of a major depressive disorder (MDD) is of clinical and scientific importance. The purpose of this paper was to provide a systematic review of the prevalence and predictors of recurrence of MDD. Method: Studies were searched in Medline en PsychINFO using the search terms 'recur*', 'relaps*', 'depress*', 'predict*' and course. Results: Recurrence of MDD in specialised mental healthcare settings is high (60% after 5 years, 67% after 10 years and 85% after 15 years) and seems lower in the general population (35% after 15 years). Number of previous episodes and subclinical residual symptoms appear to be the most important predictors. Gender, civil status and socioeconomic status seem not related to the recurrence of MDD. Conclusion: Clinical factors seem the most important predictors of recurrence. Data from studies performed in the general population and primary care on the recurrent course of MDD are scarce. © 2009 John Wiley & Sons A/S. Source

Hardeveld F.,Institute for Mental Health Care | Hardeveld F.,Netherlands Institute of Mental Health and Addiction | Spijker J.,Institute for Mental Health Care | Spijker J.,Netherlands Institute of Mental Health and Addiction | And 3 more authors.
Psychological Medicine | Year: 2013

Background Knowledge of the risk of recurrence after recovery from major depressive disorder (MDD) in the general population is scarce. Method Data were derived from 687 subjects in the general population with a lifetime DSM-III-R diagnosis of MDD but without a current major depressive episode (MDE) or dysthymia. Participants had to be at least 6 months in remission, and were recruited from The Netherlands Mental Health Survey and Incidence Study (NEMESIS), using the Composite International Diagnostic Interview (CIDI). Recency and severity of the last MDE were assessed retrospectively at baseline. Recurrence of MDD was measured prospectively during the 3-year follow-up. Kaplan-Meier survival curves were used to measure time to recurrence. Determinants of time to recurrence were analyzed using proportional hazard models. Results The estimated cumulative recurrence of MDD was 13.2% at 5 years, 23.2% at 10 years and 42.0% at 20 years. In bivariate analysis, the following variables predicted a shorter time to recurrence: younger age, younger age of onset, higher number of previous episodes, a severe last depressive episode, negative youth experiences, ongoing difficulties before recurrence and high neuroticism. Multivariably, younger age, a higher number of previous episodes, a severe last depressive episode, negative youth experiences and ongoing difficulties remained significant. Conclusions In this community sample, the long-term risk of recurrence was high, but lower than that found in clinical samples. Subjects who had had an MDE had a long-term vulnerability for recurrence. Factors predicting recurrence included illness-and stress-related factors. © 2012 Cambridge University Press. Source

Sanders J.B.,Institute for Mental Health Care | Sanders J.B.,EMGO Institute for Health and Care Research | Bremmer M.A.,EMGO Institute for Health and Care Research | Bremmer M.A.,VU University Amsterdam | And 4 more authors.
Journal of the American Geriatrics Society | Year: 2012

Objectives To investigate whether gait speed predicts incident depressive symptoms and whether depressive symptoms predict incident gait speed impairment; to ascertain the presence of shared risk factors for these associations. Design The Longitudinal Aging Study Amsterdam, a prospective cohort study with five follow-up cycles over 16 years. Setting Population based. Participants One thousand nine hundred twenty-eight respondents for incident depressive symptoms (mean age 68.9 ± 8.5) and 1,855 respondents for incident gait speed impairment (mean age 68.0 ± 8.2). Measurements Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; gait speed was measured, back and forth, during a 3-m walk as quickly as possible, with a 180° turn. Multivariate analyses were performed for both sexes using Cox regression. Results Incident depressive symptoms occurred in 24% of respondents. In univariate analyses, gait speed at baseline predicted incident depressive symptoms in men and women; after adjustment for covariates, this association persisted in men only. Examining the reverse association, 34% of respondents developed gait speed impairment. Depressive symptoms at baseline were univariately associated with incident gait speed impairment in women but not in men; this association did not persist after adjustment. The bidirectional associations did not share the same explanatory variables. Conclusion Gait speed predicts depressive symptoms in men. The geriatric giants of depressive symptoms and slowed gait speed in late life appear to result from different pathologies, both of which therefore require their own treatment strategies. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society. Source

Wekking E.M.,Institute for Mental Health Care | Wekking E.M.,University of Amsterdam | Bockting C.L.H.,University of Groningen | Koeter M.W.J.,University of Amsterdam | Schene A.H.,University of Amsterdam
Journal of Affective Disorders | Year: 2012

Background: Cognitive impairment seems to persist during the euthymic phase of recurrent depression but its relationship with future relapses as with prior course of the disease has to be elucidated. The purpose of this study is to investigate the presence and prognostic value of cognitive dysfunctions for relapse in high risk euthymic patients and to identify relevant associations between cognitive functioning and prior course of illness. Methods: Standardized neuropsychological tests of mental speed, memory and executive functioning were assessed in 137 remitted patients and compared with clinically used published normative data. Previous episodes and relapses within 24 months were measured using the Structured Clinical Interview for DSM-IV. Results: Cognitive performance was significantly impaired on 12 of the 14 variables indicating deficits in the domain of speed of information processing and memory. With Cox regression no significant neuropsychological predictors for relapse or recurrence were identified. Furthermore, Pearson correlations between neuropsychological test scores and number of previous episodes, residual depressive symptoms and duration of remission were non-significant. Later age of onset was correlated with a slower speed of information processing and lower verbal memory performance. Limitations: Published test reference data were used but no healthy control group. Conclusion: Presence of mild cognitive impairment in remitted patients was demonstrated but did not predict future relapses nor was it related with prior course of disease except for age of onset. Though, mild cognitive impairment after remission might have an impact on the quality of life, adding techniques from cognitive rehabilitation might prove to be a treatment option. © 2012 Elsevier B.V. Source

Aziz N.A.,Leiden University | Rozing M.P.,Institute for Mental Health Care
PLoS ONE | Year: 2013

Current metrics for estimating a scientist's academic performance treat the author's publications as if these were solely attributable to the author. However, this approach ignores the substantive contributions of co-authors, leading to misjudgments about the individual's own scientific merits and consequently to misallocation of funding resources and academic positions. This problem is becoming the more urgent in the biomedical field where the number of collaborations is growing rapidly, making it increasingly harder to support the best scientists. Therefore, here we introduce a simple harmonic weighing algorithm for correcting citations and citation-based metrics such as the h-index for co-authorships. This weighing algorithm can account for both the nvumber of co-authors and the sequence of authors on a paper. We then derive a measure called the 'profit (p)-index', which estimates the contribution of co-authors to the work of a given author. By using samples of researchers from a renowned Dutch University hospital, Spinoza Prize laureates (the most prestigious Dutch science award), and Nobel Prize laureates in Physiology or Medicine, we show that the contribution of co-authors to the work of a particular author is generally substantial (i.e., about 80%) and that researchers' relative rankings change materially when adjusted for the contributions of co-authors. Interestingly, although the top University hospital researchers had the highest h-indices, this appeared to be due to their significantly higher p-indices. Importantly, the ranking completely reversed when using the profit adjusted h-indices, with the Nobel laureates having the highest, the Spinoza Prize laureates having an intermediate, and the top University hospital researchers having the lowest profit adjusted h-indices, respectively, suggesting that exceptional researchers are characterized by a relatively high degree of scientific independency/originality. The concepts and methods introduced here may thus provide a more fair impression of a scientist's autonomous academic performance. © 2013 Aziz, Rozing. Source

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