Prognosis Flashcards
Dementia
Short-term: Good if treatment and social support
Long-term: Medications delay progression by about 6 months. Support can help keep a person at home.
Personality disorder
Lifelong. Tend to mitigate naturally with age - reduced aggression but relationships poor
Complications include depressive disorder, substance misuse, accidents
High suicide rates
Depression
- First episode of depression lasts 4-30 weeks for mild-moderate and 6 months on average for severe depression.
- Majority recur (30% at 10 years, 60% at 20 years)
- Recurrent episodes tend to be shorter but more severe (4-16 weeks)
- Increased risk of recurrence when residual symptoms after remission (e.g. low mood, anxiety, sleep disturbance).
Bipolar
- Average length of manic episode is 4 months.
- Runs a relapsing and remitting course in around 90%.
- Around ½ of these will have some future episodes, other ½ with persistent recurrence.
Schizophrenia
In general:
- 1/5 of people will recover entirely
- 3/5 will get better but will have relapses later in life
- 1/5 will develop a chronic course and will not have significant improvement.
GAD
Tends to be chronic and wax and wane over the patient’s lifetime.
With treatment, the likelihood of developing secondary depression is reduced
OCD
30% significantly improve
40% show moderate improvement
30% have chronic or worsening symptoms.
Suicide rates increased esp. if there is secondary depression.
Social phobia
With treatment, response rates may be up to 90%, especially with combined approaches.
Panic disorder
With treatment, functional recovery is seen in 25–75% after the first 1–2yrs.
Long-term, around 50% will experience only mild symptoms.
Alcohol dependence
In dependence, chronic relapsing
Up to 50% remain abstinent after detoxification
Anorexia nervosa
If untreated, this condition carries one of the highest mortality figures for any psychiatric disorder (10–15%).
• If treated, ‘rule of thirds’ (1/3 full recovery, 1/3 partial recovery, 1/3 chronic problems).
Bulimia nervosa
Generally good, unless there are significant issues of low self-esteem or evidence of severe personality disorder.
Somatization
tendency is for chronic morbidity with periods of relative remission
Conversion disorder
For acute conversion symptoms, especially those with a clear precipitant, the prognosis is good, with expectation of complete
Chronic fatigue
Outcome is difficult to predict but the severely affected cases and those with very chronic symptoms appear to do worse.
Depends on severity
Agoraphobia
If present continuously for a year, persistent for up to 5 years
PTSD
Majority recover in 1 year
30% have symptoms for many years
Delirium
Serious, mortality as high as 50% at one-year
Alzheimers
Life expectancy 5-8 years
Vascular
Life expectancy 4-5 years
Lewy body
Life expectancy 4-10 years, worse quality of life if also Parkinson’s features
Self-harm and suicide
15 and 25% who harmed will do so again in next year, 1-2% attempt suicide
Bipolar depression
Tends to be more severe than unipolar depressive episode, requires more treatment, more social impairment
Hypochondriasis
If untreated tends to be chronic, with varying intensity over time
Facticious disorder
Most often chronic
Opiate dependence
Chronic relapsing. 90% can withdraw sucessfully, one third will be abstinent at 7 years
Pueperal psychosis
Most recover, few remain chronically ill
Post natal depression
Without treatment 3-6 months
25% have it for a year
