Factors Associated with Psychiatric Comorbidity in Depression Patients in Primary Health Care in Chile.

Alfredo Cancino,Soledad Ballesteros-Teuber,Marcelo Leiva-Bianchi,Cristian Cáceres,Carlos Serrano,Verónica Vitriol

doi:10.1155/2018/1701978

Alfredo Cancino, Soledad Ballesteros-Teuber + Show 4 more

Open Access

https://doi.org/10.1155/2018/1701978

Copy DOI

Abstract

Objective To identify the clinical and psychosocial factors associated with psychiatric comorbidity in patients consulting for depression in Primary Health Care (PHC) in Chile. Methods 394 patients with a diagnosis of major depression being treated in a Chilean PHC were evaluated using a sociodemographic and clinical interview, the mini-international neuropsychiatric interview (MINI), a childhood trauma events (CTEs) screening, the intimate partner violence (IPV) scale, the Life Experiences Survey (LES), and the Hamilton Depression Rating Scale (HDRS). Results Positive correlations were established between higher number of psychiatric comorbidities and severity of depressive symptoms (r = 0.358), frequency of CTEs (r = 0.228), frequency of IPV events (r = 0.218), frequency of recent stressful life events (r = 0.188), number of previous depressive episodes (r = 0.340), and duration of these (r = 0.120). Inverse correlations were determined with age at the time of the first consultation (r = -0.168), age of onset of depression (r = -0.320), and number of medical comorbidities (r = -0.140). Of all associated factors, early age of the first depressive episode, CTEs antecedents, and recent stressful life events explain 13.6% of total variability in psychiatric comorbidities. Conclusions A higher prevalence of psychiatric comorbidity among subjects seeking help for depression in Chilean PHCs is associated with early onset of depression, clinical severity, chronicity, and interpersonal adversity experienced since childhood.

Highlights

Major depression is an important public health problem [1, 2]
Using the linear regression analysis (Table ), taking into account only the significant variables that in the simple analysis were correlated with the psychiatric comorbidity, it was established that the youngest age at the time of the first episode, the number of childhood trauma events (CTEs), and the number of recent stressful events were the most significant factors to best explain the psychiatric comorbidity
For each unit that increases the age of onset of the first depressive episode, the psychiatric comorbidity decreases by 0.028 points, while, for each unit that increases the number of traumatic events in childhood, the psychiatric comorbidity will increase 0.117 points and for each unit that increases the number of recent vital events, the psychiatric comorbidity will increase 0.052 points

Summary

Objective

To identify the clinical and psychosocial factors associated with psychiatric comorbidity in patients consulting for depression in Primary Health Care (PHC) in Chile. Positive correlations were established between higher number of psychiatric comorbidities and severity of depressive symptoms (r = 0.358), frequency of CTEs (r = 0.228), frequency of IPV events (r = 0.218), frequency of recent stressful life events (r = 0.188), number of previous depressive episodes (r = 0.340), and duration of these (r = 0.120). Early age of the first depressive episode, CTEs antecedents, and recent stressful life events explain 13.6% of total variability in psychiatric comorbidities. A higher prevalence of psychiatric comorbidity among subjects seeking help for depression in Chilean PHCs is associated with early onset of depression, clinical severity, chronicity, and interpersonal adversity experienced since childhood

Introduction

Methods

Results

Discussion