{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T03:40:00Z","timestamp":1768966800300,"version":"3.49.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T00:00:00Z","timestamp":1680739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004389","name":"Heidehof Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004389","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Previously established categories for the classification of disease courses of unipolar depressive disorder (relapse, remission, recovery, recurrence) are helpful, but insufficient in describing the naturalistic disease courses over time. The intention of the present study was to identify frequent disease courses of depression by means of a cluster analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For the longitudinal cluster analysis, 555 datasets of patients who participated in the INDDEP (INpatient and Day clinic treatment of DEPression) study, were used. The present study uses data of patients with at least moderate depressive symptoms (major depression) over a follow-up period of 1 year after their in-patient or day-care treatments using the LIFE (Longitudinal Interval Follow-Up Evaluation)-interview. Eight German psychosomatic hospitals participated in this naturalistic observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Considering only the Calinski\u2013Harabatz index, a 2-cluster solution gives the best statistical results. In combination with other indices and clinical interpretations, the 5-cluster solution seems to be the most interesting. The cluster sizes are large enough and numerically balanced. The KML-cluster analyses revealed five well interpretable disease course clusters over the follow-up period: \u201csustained treatment response\u201d (<jats:italic>N<\/jats:italic> = 202, 36.4% of the patients), \u201crecurrence\u201d (<jats:italic>N<\/jats:italic> = 80, 14.4%), \u201cpersisting relapse\u201d (<jats:italic>N<\/jats:italic> = 115, 20.7%), \u201ctemporary relapse\u201d (<jats:italic>N<\/jats:italic> = 95, 17.1%), and remission (<jats:italic>N<\/jats:italic> = 63, 11.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The disease courses of many patients diagnosed with a unipolar depression do not match with the historically developed categories such as relapse, remission, and recovery. Given this context, the introduction of disease course trajectories seems helpful. These findings may promote the implementation of new therapy options, adapted to the disease courses.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1081474","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T06:06:48Z","timestamp":1680761208000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Typical disease courses of patients with unipolar depressive disorder after in-patient treatments\u2013results of a cluster analysis of the INDDEP project"],"prefix":"10.3389","volume":"14","author":[{"given":"Theresa","family":"Martinek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Jarczok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edit","family":"Rottler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almut","family":"Zeeck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinz","family":"Wei\u00df","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rn","family":"von Wietersheim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,6]]},"reference":[{"key":"B1","year":"2017","journal-title":"Depression and Other Common Mental Disorders: Global Health Estimates."},{"key":"B2","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017.","volume":"392","year":"2018","journal-title":"Lancet."},{"key":"B3","year":"2019","journal-title":"Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts."},{"key":"B4","year":"2017","journal-title":"AWMF f\u00fcr die Leitliniengruppe Unipolare Depression. 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