The impact of residual symptoms on relapse and quality of life among Thai depressive patients

Figures & data

Table 1 Sociodemographic and clinical data of the participants

Sociodemographic data
Number of participants (N)	224
Age, mean (SD)	47.2 (15.2)
Sex, n (%)
Male	51 (22.8)
Female	173 (77.2)
Education, n (%)
Less than elementary	27 (12.1)
Elementary to junior	70 (31.3)
High school	57 (25.4)
Bachelor or higher	70 (31.3)
Marital status, n (%)
Single	72 (32.1)
Cohabiting or married	104 (46.4)
Living alone (widowed/divorced/separated)	48 (21.4)
In employment, n (%)
Yes	171 (76.3)
No	53 (23.7)
History of alcohol/substance abuse, n (%)	6 (2.7)
Family history of mental illnesses, n (%)
Depression	21 (10.1)
Other mental disorders	37 (16.6)
Clinical data
Diagnosis
Major depressive disorder, n (%)
First episode	117 (52.2)
Recurrent episode	81 (36.2)
Dysthymic disorder	26 (11.6)
HAMD-17
HAMD, mean (SD) (at baseline, n=346)	24.24 (6.55)
HAMD at 3-month follow-up, mean (SD) (n=224)	10.08 (8.51)
Number of patients in remission at 3-month follow-up, n (%)	114 (50.9)
Quality of life
EQ-5D at baseline, mean (SD) (n=346)	0.50 (0.21)
EQ-5D at 3-month follow-up, mean (SD) (n=224)	0.724 (0.23)
EQ-5D at 6-month follow-up, mean (SD) (n=167)	0.66 (0.23)
Visual analog scale for EQ-5D at the baseline, mean (SD) (n=346)	52.36 (21.08)
Visual analog scale for EQ-5D at 3-month follow-up, mean (SD) (n=224)	75.72 (13.87)
Visual analog scale for EQ-5D at 6-month follow-up, mean (SD) (n=167)	67.74 (17.85)
Antidepressant, n (%)
Serotonin selective reuptake inhibitors (SSRIs)	165 (73.6)
Serotonin norepinephrine reuptake inhibitors (SNRIs)	14 (6.3)
Noradrenergic and specific serotonergic antidepressants (NASSAs)	17 (7.6)
Tricyclic	8 (3.6)
Others (eg, tetracyclic, selective serotonin reuptake enhancer [SSRE])	20 (8.9)
Hypnotic-sedatives, n (%)
Trazodone	32 (14.3)
Benzodiazepine	171 (76.3)
Others	21 (9.4)

Abbreviations: HAMD, Hamilton Rating Scale for Depression; SD, standard deviation.

Table 2 The dosage of main antidepressants used in this study

Antidepressant	n	Mean dose (mg) (min–max)	SD
Fluoxetine	118	24.83 (10–60)	10.7
Sertraline	32	50.78 (25–100)	13.4
Escitalopram	14	11.43 (5–20)	4.6
Venlafaxine	11	88.64 (37.5–150)	34.7
Desvenlafaxine	1	–	–
Nortriptyline	5	47 (25–75)	25.9
Mianserin	6	27.5 (10–60)	17.9
Mirtazapine	11	23.84 (7.5–45)	11.1
Tianeptine	2	24.5 (12.5–37.5)	17.7

Abbreviation: SD, standard deviation.

Figure 1 Prevalence of residual symptoms when compared to baseline symptoms (N=224).

Figure 2 Prevalence of residual symptoms domains.

Table 3 Prevalence of residual symptoms domains according to remission status at 3 months postbaseline

Residual symptoms	Nonremission (%)	Remission (%)
Core mood symptoms	92.5	42.7
Insomnia symptoms	72.4	27.0
Anxiety symptoms	98.5	44.9
Somatic symptoms	91.0	34.8

Table 4 Summary logistic regression analysis results for residual symptoms predicting a relapse within 6 monthsa

Residual symptoms	B	SE	Wald	P-value	OR	95% CI
						Lower	Upper
Core mood symptoms	0.317	0.691	0.210	0.647	1.373	0.354	5.316
Insomnia symptoms	1.666	0.672	6.140	0.013	5.290	1.416	19.758
Anxiety symptoms	0.464	0.702	0.437	0.509	1.590	0.402	6.290
Somatic symptoms	−0.064	0.589	0.012	0.539	0.653	0.168	2.541

Note:

a Controlling for age, sex, education, and marital status and employment status.

Abbreviations: OR, odds ratio; CI, confidence interval.

Table 5 Summary of linear regression results for residual symptoms predicting the EQ-5D score at 6 month postbaseline^a,b

Clinical variables	Unstandardized coefficients		t	P-value	95% confidence interval for B
	B	Std error			Lower bound	Upper bound
EQ-5D score at the baseline	0.477	0.075	6.329	<0.001	0.328	0.626
Residual mood symptoms	−0.104	0.039	−2.670	0.008	−0.181	−0.027
Residual insomnia symptoms	−0.105	0.034	−3.109	0.002	−0.172	−0.038
Residual anxiety symptoms	−0.045	0.042	−1.066	0.288	−0.127	0.038
Residual somatic symptoms	0.012	0.036	0.344	0.732	−0.059	0.084

Notes:

a Adjusted R square (R²_adj) =0.34.

b Controlling for age, sex, education level, and marital status and employment status. Bold type = P<0.01.