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Psychiatry Res. 2019 Feb;272:602-608. doi: 10.1016/j.psychres.2018.12.178. Epub 2019 Jan 2.

The effect of chronic physical illnesses on psychiatric hospital admission in patients with recurrent major depression.

Author information

1
Department of psychological medicine, University Hospital Center Zagreb, Kispaticeva 12, HR 10000 Zagreb, Croatia. Electronic address: isimunov@kbc-zagreb.hr.
2
Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
3
Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.
4
Department of psychological medicine, University Hospital Center Zagreb, Kispaticeva 12, HR 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
5
School of Medicine, University of Zagreb, Zagreb, Croatia; Department of psychiatry, University Hospital Center Zagreb, Zagreb, Croatia.
6
Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.

Abstract

People with major depressive disorder (MDD) have an increased burden of chronic physical illnesses (CPI). However, information about the effect of CPIs on recurrent MDD treatment outcome is limited. The objective of this study was to explore whether the number of CPIs in patients with recurrent MDD was associated with higher rate of psychiatric admissions. Data were collected for a consecutive sample of 190 patients diagnosed with recurrent MDD. The key outcome was the number of psychiatric admissions following psychiatric diagnosis. The independent variable was the number of CPIs. The effects of different clinical, sociodemographic, and lifestyle confounding factors were controlled using robust regression. The patients with CPI had significantly more psychiatric admissions than the patients without CPI, and the number of CPIs was significantly associated with the number of psychiatric admissions. The results of our study largely confirmed that more than two CPIs in patients diagnosed with recurrent MDD are associated with higher rates of psychiatric admission, independent of psychiatric comorbidities and other clinical and sociodemographic factors. These findings indicate that to improve treatment outcome and to reduce recurrence, it is crucial to enhance early recognition and treatment of physical comorbidity.

KEYWORDS:

Chronic medical condition; Depression; Psychiatric comorbidity; Rehospitalization; Severe mental illness; Somatic comorbidity

PMID:
30616130
DOI:
10.1016/j.psychres.2018.12.178
[Indexed for MEDLINE]

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