Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

Figures & data

Table 1 Clinical characteristics of patients with UD or BD

Clinical characteristics	UD		BD
	Number	Percentage	Number	Percentage
Overall	146		187
Female	101	69.2	113	60.4
Age, years (mean ± SD)	37.2±12.8		26.8±9.2*
Onset age, years (mean ± SD)	35.8±13.4		24.7±9.4*
Trigger factors	73	50.0	54	28.9
Season of onset
Spring	73	50.0	92	49.2
Summer	39	26.7	40	21.4
Autumn	15	10.3	20	10.7
Winter	19	13.0	35	18.7
Risk of suicidea
0	16	11.0	20	10.7
1	25	17.1	22	11.8
2	73	50.0	83	44.4
3	21	14.4	24	12.8
4	8	5.5	11	5.9
5	3	2.0	20	10.7
Psychotic features	7	4.8	38	20.3
Duration of MDE, months (mean ± SD)	13.4±19.0		7.5±18.9
Hypersomnia	8	5.5	39	20.9
Family history of mental disorderb	30	20.5	43	23.0
Comorbidity of anxiety disordersc	44	30.1	41	21.9
Comorbidity of substance abuse	5	3.4	18	9.6
Comorbidity of physical illness	14	9.6	22	11.8
Hospitalization after the first visit	17	11.6	26	13.9
Misdiagnosis	16	11.0	87	46.5
History of spontaneous remission or switchd	18	12.3	81	43.3

Notes:

a Risk of suicide was leveled as 1: no suicidal ideation; 2: suicidal ideation but no suicidal plan; 3: suicidal plan but no suicidal attempt; 4: one suicidal attempt; 5: more than one suicidal attempts.

b Mental disorder here included psychotic disorder and mood disorder.

c Anxiety disorder here consisted of generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, phobia, somatization disorder.

d Switch means switching from depressive episode to hypomania episode.

* P<0.05.

Abbreviations: UD, unipolar depression; BD, bipolar depression; MDE, major depressive episode.

Figure 1 The Kaplan–Meier survival curves of the time to lack of persistence with treatment.

Table 2 Number (%) of patients who discontinued pharmacological treatment during the follow-up

Time (days)	Unipolar depression	Bipolar depression
0–90	60 (41.1)	84 (44.9)
90–180	17 (11.6)	26 (13.9)
180–270	18 (12.3)	14 (7.4)
270–360	6 (4.1)	12 (6.4)
Total	101 (69.2)	136 (72.7)

Table 3 Predictors of premature drop out

	UD (N=146)			BD (N=187)
	n (%)	P-value	OR (95% CI)	n (%)	P-value	OR (95% CI)
Female	102 (69.2)	0.845	1.077 (0.512–2.265)	113 (60.4)	0.012	2.250 (1.194–4.239)
Trigger factors	73 (50.0)	0.355	1.380 (0.698–2.728)	54 (28.9)	0.978	0.991 (0.517–1.899)
Age at illness onset, years (mean ± SD)	35.8±13.4	0.914	1.001 (0.976–1.027)	24.7±9.4	0.138	0.975 (0.942–1.008)
Age, years (mean ± SD)	37.2±12.8	0.524	0.991 (0.965–1.018)	26.8±9.4	0.104	0.971 (0.936–1.006)
Hospitalization after the first visit	17 (11.6)	0.310	0.543 (0.168–1.762)	26 (13.9)	0.023	0.304 (0.108–0.850)
Misdiagnosed	16 (11.0)	0.178	0.408 (0.110–1.503)	87 (46.5)	<0.01	0.283 (0.151–0.531)
Duration of MDE (months)	13.4±19.0	0.836	1.002 (0.984–1.020)	7.5±18.9	0.672	0.996 (0.977–1.015)
Risk of suicide		0.036	0.696 (0.496–0.977)		0.321	1.117 (0.898–1.391)
0	16 (11.0)			20 (10.7)
1	25 (17.1)			22 (11.8)
2	73 (50.0)			83 (44.4)
3	21 (14.4)			24 (12.8)
4	8 (5.5)			11 (5.9)
5	3 (2.0)			20 (10.7)
Season of onset
Spring	73 (50.0)	0.066	1.00 (ref)	92 (49.2)	0.025	1.0 (ref)
Summer	39 (26.7)	0.049	4.702 (1.007–21.966)	40 (21.4)	0.073	2.138 (0.932–4.904)
Autumn	15 (10.3)	0.012	7.690 (1.566–37.756)	20 (10.7)	0.326	1.616 (0.620–4.209)
Winter	19 (13.0)	0.234	3.091 (0.482–19.838)	35 (18.7)	0.108	0.261 (0.051–1.342)
Family history of mental disorder	30 (20.5)	0.267	1.590 (0.701–3.607)	43 (23.0)	0.461	1.296 (0.650–2.584)
Comorbidity of anxiety disorder	44 (30.1)	<0.01	0.159 (0.058–0.436)	41 (21.9)	0.144	0.577 (0.276–1.206)
Comorbidity of substance abuse	5 (3.4)	0.999	0.000 (0.000–∝)	18 (9.6)	0.801	0.880 (0.324–2.386)
Comorbidity of physical illness	14 (9.6)	0.502	1.467 (0.480–4.485)	22 (11.8)	0.412	0.669 (0.256–1.748)
Psychotic features	7 (4.8)	0.279	0.306 (0.036–2.616)	38 (20.3)	0.694	1.156 (0.560–2.388)
Hypersomnia	8 (5.5)	0.557	0.612 (0.119–3.149)	39 (20.9)	0.235	0.637 (0.303–1.341)
History of spontaneous remission or switch	158 (12.3)	0.897	0.993 (0.328–2.653)	81 (43.3)	0.004	2.470 (1.345–4.536)

Note: Values in bold represent significantly significant results.

Abbreviations: UD, unipolar depression; BD, bipolar depression; OR, odds ratio; MDE, major depressive episode.