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American Journal of Epidemiology Vol. 149, No. 5: 404-411
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health

other

Recurrence in Affective Disorder: Analyses with Frailty Models

Lars Vedel Kessing1,, Elisabeth Wreford Olsen2, Per Kragh Andersen2 and in cooperation with the Department of Psychiatric Demography, University of Aarhus, Psychiatric Hospital, Risskov, Denmark

1Department of Psychiatry, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
2Department of Biostatistics, University of Copenhagen Copenhagen, Denmark

Reprint requests to Dr. Lars Vedel Kessing, Department of Psychiatry, Rigshospitalet, Blegdamsvej 9, DK 2100 Copenhagen Ø, Denmark.

The risk of recurrence in affective disorder is influenced by the number of prior episodes and by a person's tendency toward recurrence. Newly developed frailty models were used to estimate the effect of the number of episodes on the rate of recurrence, taking into account individual frailty toward recurrence. The study base was the Danish psychiatric case register of all hospital admissions for primary affective disorder in Denmark during 1971–1993. A total of 20, 350 first-admission patients were discharged with a diagnosis of major affective disorder. For women with unipolar disorder and for all kinds of patients with bipolar disorder, the rate of recurrence was affected by the number of prior episodes even when the effect was adjusted for individual frailty toward recurrence. No effect of episodes but a large effect of the frailty parameter was found for unipolar men. The authors concluded that the risk of recurrence seems to increase with the number of episodes of bipolar affective disorder in general and for women with unipolar disorder. Am J Epidemiol 1999; 149: 404–11.

affective disorders; bipolar disorder; depressive disorder; recurrence


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