Purpose The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) is regarded as the most acceptable tool for measuring obsessive–compulsive disorder symptom severity. Recently, the Yale–Brown Obsessive Compulsive Scale – Second Edition (Y-BOCS-II) was developed for better measurement. The study reported here aimed to evaluate the psychometric properties of the Thai version of the Yale–Brown Obsessive Compulsive Scale – Second Edition (Y-BOCS-II-T). Patients and methods The original version of the Y-BOCS-II was translated into Thai, which involved forward translation, synthesis of the translation, and back translation. Modification and cross-cultural adaptation were completed accordingly. The developed Y-BOCS-II-T, together with the Hamilton Rating Scale for Depression, was administered to 41 patients who had a primary diagnosis of obsessive–compulsive disorder. The patients then completed the Pictorial Thai Quality of Life instrument and Patient Health Questionnaire. Lastly, the Global Assessment of Functioning (GAF) and the Clinical Global Impression – Severity Scale (CGI-S) of all patients were blindly rated by another experienced psychiatrist who was not the interviewer. Results The mean total score of the Yale–Brown Obsessive Compulsive Scale – Second Edition – Severity Scale (Y-BOCS-II-SS) and the Yale–Brown Obsessive Compulsive Scale – Second Edition – Symptom Checklist (Y-BOCS-II-SC) were 18.44 (standard deviation =10.51) and 15.85 (standard deviation =9.58), respectively. The Y-BOCS-II-T had satisfactory internal consistency (Cronbach’s alpha =0.94 for the Severity Scale, and Kuder–Richardson Formula 20 =0.90 for the Symptom Checklist). Inter-rater reliability was excellent for both the Y-BOCS-II-SS and Y-BOCS-II-SC. Factor analysis of Y-BOCS-II-SS items revealed a two-factor component associated with obsession and compulsion. The Y-BOCS-II-SS correlated highly with the CGI-S and GAF ( r =0.75 and −0.76, respectively), but the Y-BOCS-II-SC correlated moderately ( r =0.42 for CGI-S; r =−0.39 for GAF). The Y-BOCS-II-SS and Y-BOCS-II-SC slightly to moderately correlated with the Hamilton Rating Scale for Depression, Patient Health Questionnaire, and Pictorial Thai Quality of Life, which might indicate the comorbidity depression and its effect on quality of life. Conclusion The Y-BOCS-II-T is a psychometrically reliable and valid measure for the assessment of both severity and characteristics of obsessive–compulsive symptoms in Thai clinical samples.
PurposeResidual symptoms of depressive disorder are major predictors of relapse of depression and lower quality of life. This study aims to investigate the prevalence of residual symptoms, relapse rates, and quality of life among patients with depressive disorder.Patients and methodsData were collected during the Thai Study of Affective Disorder (THAISAD) project. The Hamilton Rating Scale for Depression (HAMD) was used to measure the severity and residual symptoms of depression, and EQ-5D instrument was used to measure the quality of life. Demographic and clinical data at the baseline were described by mean ± standard deviation (SD). Prevalence of residual symptoms of depression was determined and presented as percentage. Regression analysis was utilized to predict relapse and patients’ quality of life at 6 months postbaseline.ResultsA total of 224 depressive disorder patients were recruited. Most of the patients (93.3%) had at least one residual symptom, and the most common was anxiety symptoms (76.3%; 95% confidence interval [CI], 0.71–0.82). After 3 months postbaseline, 114 patients (50.9%) were in remission and within 6 months, 44 of them (38.6%) relapsed. Regression analysis showed that residual insomnia symptoms were significantly associated with these relapse cases (odds ratio [OR] =5.290, 95% CI, 1.42–19.76). Regarding quality of life, residual core mood and insomnia significantly predicted the EQ-5D scores at 6 months postbaseline (B =−2.670, 95% CI, −0.181 to −0.027 and B =−3.109, 95% CI, −0.172 to −0.038, respectively).ConclusionResidual symptoms are common in patients receiving treatment for depressive disorder and were found to be associated with relapses and quality of life. Clinicians need to be aware of these residual symptoms when carrying out follow-up treatment in patients with depressive disorder, so that prompt action can be taken to mitigate the risk of relapse.
BackgroundThe Thai Study of Affective Disorders was a tertiary hospital-based cohort study developed to identify treatment outcomes among depressed patients and the variables involved. In this study, we examined the baseline characteristics of these depressed patients.MethodsPatients were investigated at eleven psychiatric outpatient clinics at tertiary hospitals for the presence of unipolar depressive disorders, as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The severity of any depression found was measured using the Clinical Global Impression and 17-item Hamilton Depression Rating Scale (HAMD) clinician-rated tools, with the Thai Depression Inventory (a self-rated instrument) administered alongside them. Sociodemographic and psychosocial variables were collected, and quality of life was also captured using the health-related quality of life (SF-36v2), EuroQoL (EQ-5D), and visual analog scale (EQ VAS) tools.ResultsA total of 371 outpatients suffering new or recurrent episodes were recruited. The mean age of the group was 45.7±15.9 (range 18–83) years, and 75% of the group was female. In terms of diagnosis, 88% had major depressive disorder, 12% had dysthymic disorder, and 50% had a combination of both major depressive disorder and dysthymic disorder. The mean (standard deviation) scores for the HAMD, Clinical Global Impression, and Thai Depression Inventory were 24.2±6.4, 4.47±1.1, and 51.51±0.2, respectively. Sixty-two percent had suicidal tendencies, while 11% had a family history of depression. Of the major depressive disorder cases, 61% had experienced a first episode. The SF-36v2 component scores ranged from 25 to 56, while the mean (standard deviation) of the EQ-5D was 0.50±0.22 and that of the EQ VAS was 53.79±21.3.ConclusionThis study provides an overview of the sociodemographic and psychosocial characteristics of patients with new or recurrent episodes of unipolar depressive disorders.
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