Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención

Salvo, Lilian; Saldivia, Sandra; Parra, Carlos; Rodríguez, R.; Cifuentes, Manuel; Acevedo, Paola; Díaz, Marcela; Ormazabal, Mitza; Guerra, Ivonne; Navarrete, Nicol; Bravo, Verónica; Castro, Andrea

doi:10.4067/s0034-98872017000300007

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…Finally, it is important to note that almost 50% of patients of this sample failed to remit at 12 months. This result, which is consistent with the current literature [ 8 - 15 ], is associated with factors that can be recognized during the first consultation at PHC [ 45 - 47 ].…”

Section: Discussionsupporting

confidence: 93%

Remission in Depression and Associated Factors at Different Assessment Times in Primary Care in Chile

Vitriol

Cancino

Serrano

et al. 2018

CPEMH

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Objective: To determine the factors associated with remission at 3, 6, 9 and 12 months among depressive adult patients in primary care [PHC] in Chile.Methods: This is a one-year naturalistic study that followed 297 patients admitted for treatment of depression in eight primary care clinics in Chile. Initially, patients were evaluated using: the International Mini-Neuropsychiatric Interview [MINI], a screening for Childhood Trauma Events [CTEs], the Life Experiences Survey and a partner violence scale. The Hamilton Depression Scale [HDRS] was used to follow the patients during the observation time. Associations between the factors studied and the primary outcome remission [HDRS ≤ 7] were assessed using a dichotomous logistic regression and a multivariate Poisson regression. The significance level was 0.05.Results: Remission [HDRS ≤ 7] ranged between 36.7% at 3 months and 53.9% at 12 months. Factors that predicted poor remission during the observation time were: CTEs [Wald X2 = 4.88, Exp B=0.94, CI 0.90-0.92, p=0.27]; psychiatric comorbidities [Wald X2 = 10.73, Exp B=0.90, CI 0.85-0.96, p=0.01]; suicidal tendencies [Wald X2 = 4.66, Exp B=0.88, CI 0.79-0.98, p=0.03] and prior treatment for depression [Wald X2 = 4.50, Exp B=0.81, CI 0.68-0.85, p=0.03]Discussion: Almost 50% of this sample failed remission in depression at 12 months. Psychiatric comorbidities and CTEs are factors that should be considered for a poor outcome in depressed Chilean patients. These factors need more recognition and a better approach in PHC.

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Section: Discussionsupporting

confidence: 93%

Remission in Depression and Associated Factors at Different Assessment Times in Primary Care in Chile

Vitriol

Cancino

Serrano

et al. 2018

CPEMH

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“…Si bien, en Chile existen estudios sobre factores vinculados al curso clínico del TDM (17) , no se han descrito trayectorias de respuesta en estos pacientes. Por lo tanto, el objetivo de este estudio es describir las trayectorias de respuesta en pacientes con TDM en tratamiento en centros de atención primaria en Chile.…”

Section: Introductionunclassified

Estudio prospectivo descriptivo de las trayectorias de respuesta terapéutica en una cohorte de pacientes con trastorno depresivo mayor

Vargas,

Aguilera,

Arancibia

et al. 2023

Rev. chil. neuro-psiquiatr.

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Introduction: Major depressive disorder (MDD) is a public health problem due to its high prevalence and biopsychosocial consequences. It is a clinically heterogeneous and complex disorder with a fluctuating course. In Chile, there are no studies on clinical trajectories in MDD. Objective: To describe the clinical response trajectories in patients with MDD under treatment in primary care centers (PCC) in Chile. Method: We conducted a prospective cohort study with a five-month follow-up, including patients treated in the Explicit Guarantees in Healthcare program for depression at seven PCC in the Valparaíso Region, Chile. We carried out four evaluations (weeks 0, 4, 12 and 20) to describe various clinical and sociodemographic variables related to the therapeutic evolution. We elaborated response trajectories in relation to the course of depressive symptoms. Results: 159 participants were included (93% women), with an average age of 43 years old. The most frequently reported risk conditions for MDD were social isolation or poor support network and having witnessed domestic violence during childhood. Twelve response trajectories were obtained from a total of 16 possible patterns. Differences were observed when analyzing the therapeutic responses between weeks 0 and 12 and 0 and 20. The most frequent trajectories were the maintenance or worsening of depressive symptoms (37.7%). Conclusions: The results show a symptomatic variability during the course of MDD. In this five-month follow-up, more than a third of the participants did not improve their depressive symptoms.

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“…Predictores de remisión del trastorno depresivo de mayor gravedad -l. salvo et al44 . No hubo recurrencias durante el seguimiento.…”

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Predictores de remisión del trastorno depresivo mayor en tratamiento en el nivel secundario de atención

Salvo

Saldivia

Parra³

et al. 2017

Rev. méd. Chile

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Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

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Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención

Abstract: artículo de investigación rev Med chile 2017; 145: 335-343 Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención (Rev Med Chile 2017; 145: 335-343)

Cited by 3 publications

References 34 publications

Remission in Depression and Associated Factors at Different Assessment Times in Primary Care in Chile

Remission in Depression and Associated Factors at Different Assessment Times in Primary Care in Chile

Estudio prospectivo descriptivo de las trayectorias de respuesta terapéutica en una cohorte de pacientes con trastorno depresivo mayor

Predictores de remisión del trastorno depresivo mayor en tratamiento en el nivel secundario de atención

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