Clinical Practice & Epidemiology in Mental Health




ISSN: 1745-0179 ― Volume 14, 2018
RESEARCH ARTICLE

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



Veronica Vitriol1, *, Alfredo Cancino1, Carlos Serrano2, Soledad Ballesteros1, Soledad Potthoff3
1 Medicine School, Universidad de Talca, Talca, Chile
2 Psychology School, Universidad de Talca, Talca, Chile
3 Neurosciences Institute, Viña del Mar, Chile

Abstract

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.

Keywords: Depression, Remission, Primary health care, Child abuse, Logistic, Dichotomous.


Article Information


Identifiers and Pagination:

Year: 2018
Volume: 14
First Page: 78
Last Page: 88
Publisher Id: CPEMH-14-78
DOI: 10.2174/1745017901814010078

Article History:

Received Date: 04/12/2017
Revision Received Date: 14/01/2018
Acceptance Date: 15/02/2018
Electronic publication date: 26/03/2018
Collection year: 2018

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© 2018 Vitriol et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Medicine School, Universidad de Talca, Lircay s/n, Talca, Chile; Tel: 56752317471; E-mails:verovitriol@gmail.com, vvitriol@utalca.cl


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