Quality of life, disability, and residual depressive symptoms in older remitted and partly remitted patients with major depressive disorder/ Remisyondaki ve kismi remisyondaki major depresif bozukluk tanili geriyatrik hastalarda kalinti depresyon belirtileri, yasam kalitesi ve yeti yitimi uzerine etkileri

• Published in: Anadolu psikiyatri dergisi Vol. 21; no. 1; p. 45
• Main Authors: Tulaci, Riza Gokcer, Ekinci, Okan
• Format: Journal Article
• Language: Turkish
• Published: Anadolu Psikiyatri Dergisi 01.02.2020
• Subjects: Analysis; Depression (Mood disorder); Disabilities; Elderly patients; Glucocorticoids; Health aspects; Risk factors
• DOI: 10.5455/apd.47873
• ISSN: 1302-6631

Objective: To determine associations between remission status, residual symptoms, quality of life (QoL) subdomains and disability and to examine predictive role of specific residual symptoms on disability and QoL in elderly patients (age>60) with depression. Methods: One hundred and sixty patients who had initially been diagnosed with MDD, were randomized into two groups (partly remitted (PRD) vs remitted (RD). By using the 17-item Hamilton Rating Scale for Depression (HAM-D), PRD was defined as a score between 8 and 18 and RD as a score of [less than or equal to] 7. Residual symptoms were assessed using the HAM-D. QoL and disability were measured using SF-36 and WHODAS 2.0, respectively. Results: Among the PRD, 94.2% of them were experiencing at least one residual symptom (HAM-D symptom subscore [greater than or equal to] 1). Among the RD, 48.2% of them were experiencing at least one residual symptom. Most of the SF-36 subscores were substantially higher in subjects with RD than in PRD subjects. There were significant correlations between QoL, disability and specific residual symptoms. In the Beta regression analyses, there were different and specific residual symptoms and clinical risk factors for each SF-36 domain. Conclusions: Residual symptoms are found common in both partial and full remitters in older patients with MDD and were significantly associated with disability and QoL in older depressive patients. Given the negative impact of residual symptoms and partial remission status on functionality and QoL, more attention needs to treat effectively depressive episodes. (Anatolian Journal of Psychiatry 2020; 21(1):45-52) Keywords: depression, older age, quality of life, residual sign, remitted Amac: Calismanin amaci depresif bozuklugu olan geriyatrik hasta populasyonunda reziduel (kalinti) depresyon belirtilerini, bu belirtilerin hastalarin islevselligi ve yeti yitimi uzerine olan etkilerini ve ozgul residuel belirtilerin yeti yitimi uzerindeki yordayici etkilerini arastirmaktir. Yontem: Calismaya depresif bozukluk tanisi ile tedavi gormekte olan 160 hasta ([greater than or equal to] 60) ve 80 ([greater than or equal to] 60) saglikli gonullu alindi. Hastalar 'remisyonda depresyon' ve 'kismi remisyonda depresyon' grubu olarak ikiye ayrildi. Hamilton Depresyon Derecelendirme Olcegi (HAMD- 17) puani [less than or equal to] 7 olanlar remisyonda depresyon grubunu, HAMD-17 puani 8-18 arasinda olan ve major depresyon tanisini karsilamayan hastalar ise 'kismi remisyonda depresyon' gurubunu olusturdu. Reziduel belirtiler (HAMD-17) formu kullanilarak belirlendi. Katilimcilarin yasam kalitesi Kisa Form 36 Yasam Kalitesi Olcegi (SF-36), yeti yitimi Dunya Saglik Orgutu Yeti Yitimi Degerlendirme Formu kullanilarak olculdu. Sonuclar: 'Kismi remisyonda depresyon' gurubunun %94.2'--sinde ve 'remisyondaki depresyon' grubunun ise %48.2'sinde en az bir kalinti depresyon belirtisi (HAM-D belirti alt grup puani [greater than or equal to] 1) vardi. Remisyondaki depresyon grubunda SF-36 alt olceklerinin bircogu 'kismi remisyonda grubundan belirgin derecede yuksek (daha iyi yasam kalitesi) idi. Hastalarin ozgul kalinti depresyon belirtileri ile yeti yitimi ve yasam kalitesi degerlendirme sonuclari arasinda anlamli derecede iliski vardi. Tartisma: Depresif bozukluk tanisi ile tedavi goren hem remisyondaki, hem de kismi remisyondaki hastalarda siklikla cesitli derecelerde kalinti belirti olmaktadir. Kalinti belirtilerin yasam kalitesi ve yeti yitimi uzerine olumsuz etkileri vardir. Bu hasta grubunun kalinti belirtilerin varligi ve tedavisi acisindan dikkatle izlenmesi daha iyi tedavi sonuclari alinmasi bakimindan onem tasimaktadir. (Anadolu Psikiyatri Derg 2020; 21(1):45-52) Anahtar sozcukler: Depresyon, geriyatri, yasam kalitesi, kalinti belirti, remisyon