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

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 2...

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Main Authors: Verónica Vitriol, Alfredo Cancino, Catalina Bustamante, María de la Luz Aylwin
Format: Article
Language:English
Published: SAGE Publishing 2024-04-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319241241476
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author Verónica Vitriol
Alfredo Cancino
Catalina Bustamante
María de la Luz Aylwin
author_facet Verónica Vitriol
Alfredo Cancino
Catalina Bustamante
María de la Luz Aylwin
author_sort Verónica Vitriol
collection DOAJ
description 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 ( X 2 90.06, P  < .001, Kruskal-Wallis test, η 2  = 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.
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spelling doaj.art-f4fef6b427f040c695901745402f34fd2024-04-09T10:03:30ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272024-04-011510.1177/21501319241241476Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in ChileVerónica Vitriol0Alfredo Cancino1Catalina Bustamante2María de la Luz Aylwin3University of Talca, Talca, ChileUniversity of Talca, Talca, ChileUniversity of Talca, Talca, ChileUniversity of Talca, Talca, ChileObjective: 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 ( X 2 90.06, P  < .001, Kruskal-Wallis test, η 2  = 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.https://doi.org/10.1177/21501319241241476
spellingShingle Verónica Vitriol
Alfredo Cancino
Catalina Bustamante
María de la Luz Aylwin
Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
Journal of Primary Care & Community Health
title Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
title_full Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
title_fullStr Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
title_full_unstemmed Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
title_short Evolution of Depressive Symptoms Among Depression Subtypes of Clinical and Functional Variables in Primary Care in Chile
title_sort evolution of depressive symptoms among depression subtypes of clinical and functional variables in primary care in chile
url https://doi.org/10.1177/21501319241241476
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