The impact of residual symptoms on relapse and quality of life among Thai depressive patients
Received 10 October 2016
Accepted for publication 16 November 2016
Published 12 December 2016 Volume 2016:12 Pages 3175—3181
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Wai Kwong Tang
Thanita Hiranyatheb,1 Daochompu Nakawiro,1 Tinakon Wongpakaran,2 Nahathai Wongpakaran,2 Putipong Bookkamana,3 Manee Pinyopornpanish,2 Nattha Saisavoey,4 Kamonporn Wannarit,4 Sirina Satthapisit,5 Sitthinant Tanchakvaranont6
1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 2Department of Psychiatry, Faculty of Medicine, 3Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, 4Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 5Department of Psychiatry Khon Kaen Hospital, Khon Kaen, 6Department of Psychiatry, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand
Purpose: Residual 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 methods: Data 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.
Results: A 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).
Conclusion: Residual 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.
Keywords: Thai, residual symptoms, depression, relapse, quality of life, treatment
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