Paula S Lestelä-Mielonen

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BACKGROUND Information on the naturalistic outcome of major depressive disorder (MDD) is important in developing rational clinical practices. The aim of this study was to determine the outcome of MDD in a modern secondary-level psychiatric setting and the influence of comorbidity plus psychosocial factors on the outcome of MDD. METHOD The Vantaa(More)
BACKGROUND New antidepressants emerged and became widely used during the 1990s. The present study investigated quality-of-care problems in the treatment of depression in a current psychiatric setting. METHOD We investigated the treatment received for depression by all 803 inpatients or outpatients with a clinical diagnosis of ICD-10 depressive episode or(More)
BACKGROUND While numerous studies have documented the high comorbidity of major depressive disorder (MDD) with individual mental disorders, no published study has reported overall current comorbidity with all Axis I and II disorders among psychiatric patients with MDD, nor systematically investigated variations in current comorbidity by sociodemographic(More)
BACKGROUND Adverse life events and social support may influence the outcome of major depressive disorder (MDD). We hypothesized that outcome would depend on the level of depressive symptoms present at the outset, with those in partial remission being particularly vulnerable. METHOD In the Vantaa Depression Study (VDS), patients with DSM-IV MDD were(More)
OBJECTIVE Several evidence-based treatment guidelines for major depressive disorder (MDD) have been published. However, little is known about how recommendations for treatment are adhered to by patients in current usual psychiatric practice. METHOD The Vantaa Depression Study is a prospective, naturalistic cohort study of 269 psychiatric patients with a(More)
BACKGROUND Few studies have investigated risk factors for suicidal ideation and attempts, or possible variations in them, among representative samples of psychiatric patients with major depressive disorder. METHOD As part of the Vantaa Depression Study in Vantaa, Finland, 269 patients with DSM-IV major depressive disorder (MDD), diagnosed by interview(More)
BACKGROUND There are few prospective studies on risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder. AIMS To investigate risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder in the city of Vantaa, Finland. METHOD The Vantaa Depression Study included(More)
BACKGROUND The descriptive validity of the melancholic features specifier of the DSM-IV major depressive disorder (MDD) is uncertain. Little is known about its relationship to psychiatric co-morbidity, stability across episodes, or strength in predicting course of illness. METHOD The Vantaa Depression Study (VDS) is a prospective, naturalistic cohort(More)
The impact of persistent depression on social support (SS) is not well known. In the Vantaa Depression Study (VDS), 193 patients with DSM-IV MDD were interviewed at baseline, at 6 and 18 months. Objective SS was measured with the Interview Measure of Social Relationships (IMSR), and subjective SS with the Perceived Social Support Scale-Revised (PSSS-R); the(More)
OBJECTIVE Major Depressive Disorder (MDD) is a major cause of long-term work disability. However, factors predicting this are not well known. METHOD In the Vantaa Depression Study, predictors for being granted a disability pension during an 18-month follow-up were examined among the 186 psychiatric MDD in- and out-patients belonging to the labour force at(More)