Latent Class Analysis in Depression, Including Clinical and Functional Variables: Evidence of a Complex Depressive Subtype in Primary Care in Chile

Vitriol, Verónica; Cancino, Alfredo; Serrano, Carlos; Ballesteros, Soledad; Ormazábal, Marcela; Leiva-Bianchi, Marcelo; Salgado, Carolina Martínez; Cáceres, Cristian; Potthoff, Soledad; Orellana, Francisca; Asenjo, Andrea

doi:10.1155/2021/6629403

Cited by 3 publications

(9 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 11 - 13 Moreover, a recent latent class analysis identified 3 distinct subtypes based on clinical and functional variables: complex depression, recurrent depression, and unique depression. 14 The complex subtype, representing half of the studied sample, stands out due to its significantly higher likelihood of individuals having a history of suicide attempts, interpersonal difficulties, impaired social functioning, and association with adverse childhood experiences (ACEs). 14 The presence of psychiatric comorbidities distinguishes recurrent depression from unique depression.…”

Section: Introductionmentioning

confidence: 99%

“… 14 The complex subtype, representing half of the studied sample, stands out due to its significantly higher likelihood of individuals having a history of suicide attempts, interpersonal difficulties, impaired social functioning, and association with adverse childhood experiences (ACEs). 14 The presence of psychiatric comorbidities distinguishes recurrent depression from unique depression. 14 …”

Section: Introductionmentioning

confidence: 99%

“… 14 The presence of psychiatric comorbidities distinguishes recurrent depression from unique depression. 14 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile

Vitriol,

Cancino,

Bustamante

et al. 2024

J Prim Care Community Health

Self Cite

View full text Add to dashboard Cite

Objective: To compare the evolution of depressive symptoms among depressive subtypes based on clinical and functional variables in a sample of primary care in Chile. Methods: A longitudinal study was conducted in the Maule Region of Chile, focusing on 8 primary care from February 2014 to September 2015. Clinical and functional variables, including Mini International Neuro-psychiatric Interview, Outcome Questionnaire interpersonal and social sub-scales, were applied in a latent class analysis. This analysis categorized 210 patients into 3 subtypes: complex depression (N = 100), recurrent depression (n = 96), and unique depression (n = 14). Complex depression, exhibited a higher probability of suicide attempts, interpersonal and social dysfunction, and association with adverse childhood experiences according the Brief Physical and Sexual Abuse Questionnaire. Patients were monitored over 1 year with the Hamilton scale. The Kruskal-Wallis, non-parametric test, followed by paired Mann-Whitney test evaluated difference in the severity of depressive symptoms between the groups. Additionally, data on mental health interventions were collected. Results: Out of the 210 patients, 89% were women, with a median age of 50 (range 37-58), and 40.1% with only primary education. Sociodemographic characteristics not differ between groups. Significant differences in depressive symptom severity between the groups were found ( X2 90.06, P < .001, Kruskal-Wallis test, η2 = 0.084). Post hoc analyses indicated higher depressive symptoms in complex depression compared to recurrent ( Z = −9.501, P < .001) and unique ( Z = −2.877, P = .004) depression, with no significant difference between recurrent and unique depression ( Z = −1.58, P = .113). There were no differences in the number of medical and psychological controls between the groups. The patients with complex depression required greater modifications in the pharmacological prescriptions than those belonging to the other groups. Conclusion These results provide additional evidence of a complex depression subtype in primary care in Chile associated with adverse childhood experiences, that had worse resolution of depressive symptoms. Contrary to expectations, patients belonging to this group did not receive further medical and psychological interventions, probably due to a lack of specific clinical recommendations.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile

Vitriol,

Cancino,

Bustamante

et al. 2024

J Prim Care Community Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…10,11 Using latent class analysis, our group found evidence of a complex depressive subtype. 12 This subtype, whose frequency is about half of the sample studied, is characterized by a history of suicide attempts, history of adverse life experiences, interpersonal difficulties, impairment in social functioning, and poor treatment response. 12 These characteristics, which have been reported in refractory depression, 13 can be understood in light of the neurobiological sequelae of exposure to psychological trauma.…”

mentioning

confidence: 99%

“…12 This subtype, whose frequency is about half of the sample studied, is characterized by a history of suicide attempts, history of adverse life experiences, interpersonal difficulties, impairment in social functioning, and poor treatment response. 12 These characteristics, which have been reported in refractory depression, 13 can be understood in light of the neurobiological sequelae of exposure to psychological trauma. 14 Currently, there are a lack of recommendations in depression treatment guidelines regarding the needs of patients with this complex clinical picture.…”

mentioning

confidence: 99%

Effect of a collaborative multidimensional approach versus usual care on the resolution of adult depression in primary care in Chile: study protocol for a single blinded cluster randomized controlled trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: Major depression (MD) is a prevalent and disabling condition in Chile. Most MD cases are treated at the primary care level. In Chilean primary care, the authors have gathered evidence of a prevalent complex depression subtype associated with a worse prognosis and characterized by interpersonal difficulties, suicidality and trauma history. This MD presentation suggests the need for a multidimensional, trauma-informed and interprofessional approach. The present study protocol describes the context, hypotheses and methods for a cluster randomized control trial (RCT) comparing a collaborative multidimensional approach and usual care in treatment outcomes of MD in primary care in Chile. Methods: This is a two-arm, single-blinded, cluster RCT to compare the efficacy of a collaborative multidimensional approach for depression (CMAD) versus usual care to treat MD in primary care clinics in Chile. In total, 394 depressed adults from 18 to 65 years of age in twelve clinics located in Chile’s Maule Region will be consented to participate in the study. Patients and care teams from each clinic will be randomized to the intervention or to the control arm. Interprofessional teams in the intervention arm will attend 27 hours of didactic and active learning sessions focused on clinical competences to effectively engage, treat and follow up patients with complex presentation of MD. Team in the control arm will receive 27 didactic sessions on current clinical guidelines for MD, professionals in both arms will receive 27 hours of continued education. Discussion: To improve treatment outcomes of MD in Chile, primary care teams should develop clinical competencies relevant to complex, difficult-to-treat types of MD within collaborative and trauma-informed approaches.

show abstract

Latent class of depressive symptoms of and its determinants: A cross-sectional study among Iranian University students

Aleebrahim,

Heidari,

Yousefnejad

et al. 2024

Journal of Research in Medical Sciences

View full text Add to dashboard Cite

Background: According to the report of the World Health Organization, mental disorders are one of the 10 most important causes of disability in the world. This study was conducted with the aim of determining the number and frequency of latent classes of depression and its determinants in Isfahan university of medical students. Materials and Methods: A total of 1408 medical students from Isfahan University of Medical Sciences, Iran, were enrolled in the study in 2017. The symptoms and severity of depression were assessed using the standard Hospital Anxiety and Depression scale questionnaire. Latent class analysis was applied to seven symptoms of depression, all of which had four levels. Latent class subgroups were compared using the Chi-square test and analysis of variance test. The regression model was used to check the relationship between identified classes and related factors. Analyzes were done using SPSS-21 and Mplus7 software. Results: In this study, three latent classes were identified, that is, the group of healthy people, the group of borderline people, and the group of people suspected of depression. The prevalence of identified latent classes among medical students is 0.52, 0.32, and 0.16%, respectively. The regression results showed that compared to the healthy group, the factors affecting depression in the borderline and suspicious group were increasing age, female gender, interest in the field of study, physical activity, history of depression, and history of anxiety. Conclusion: The three classes that were identified based on the students’ answers to the depression symptoms questions differed only based on severity. The history of depression and anxiety were the strongest predictors of latent classes of depression.

show abstract

Latent Class Analysis in Depression, Including Clinical and Functional Variables: Evidence of a Complex Depressive Subtype in Primary Care in Chile

Cited by 3 publications

References 70 publications

Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile

Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile

Effect of a collaborative multidimensional approach versus usual care on the resolution of adult depression in primary care in Chile: study protocol for a single blinded cluster randomized controlled trial

Latent class of depressive symptoms of and its determinants: A cross-sectional study among Iranian University students

Contact Info

Product

Resources

About