Medical comorbidity in recurrent versus first-episode depressive patients

• Published in: Acta psychiatrica Scandinavica 2011-03, Vol.123 (3), p.220-227
• Main Authors: Gili, M., Garcia-Toro, M., Vives, M., Armengol, S., Garcia-Campayo, J., Soriano, J. B., Roca, M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Affective disorders; Age; Age Factors; Aged; Biological and medical sciences; Body Mass Index; Comorbidity; Confidence Intervals; Cross-Sectional Studies; Data processing; Depression; Depressive Disorder, Major - epidemiology; Educational Status; Epidemiology; Female; general practice; Headache; Humans; Logistic Models; Male; medical records; Medical sciences; Mental depression; Middle Aged; Migraine; Mood disorders; Morbidity; Myocardial infarction; Odds Ratio; physical illness; Primary care; Psoriasis; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radiology; Recurrence; Risk Factors; Sex Factors; Socio-economic aspects; Socioeconomic Factors; Spain - epidemiology; Statistical analysis; Young Adult
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.2010.01646.x

Gili M, Garcia‐Toro M, Vives M, Armengol S, Garcia‐Campayo J, Soriano JB, Roca M. Medical comorbidity in recurrent versus first‐episode depressive patients. Objective:  This study compares the comorbidity of affective disorders and medical diseases in primary care patients with either a first or recurrent depressive episode. Method:  A cross‐sectional epidemiological study in primary care centres in Spain was designed. A total of 10 257 primary care patients suffering a DSM‐IV major depressive episode (MDD) were analysed. Depression was assessed using the Montgomery–Asberg Depression Rating Scale (MADRS), and World Health Organization (WHO) medical diagnoses were provided by the patient’s general practitioner according to medical records revised on the basis of radiology or laboratory test data. Results:  A total of 88.6% of recurrent patients and 71.1% of first‐episode depressive patients reported a medical condition (aOR = 2.61, CI = 2.31–2.93). All medical conditions were more prevalent in the recurrent group than in first‐episode group, and with the exception of myocardial infarction, psoriasis and migraine, all other crude ORs showed statistically significant differences between first‐ and recurrent episodes patients after adjusting for gender, age, education, socioeconomic status and body mass index (BMI). Conclusion:  Recurrent depression is associated with a decrement in health that is significantly greater than in first‐episode depression. Special attention needs to be paid to the physical health in the middle‐ and long‐term management of patients with affective disorders.