title: Psychosocial aspects of resistance in complex treatment of depressive disorder.
abstract: OBJECTIVE
  Treatment of major depressive disorder can be affected by a broad range of factors. In our study, we focused on the relationships of demographic, psychological, clinical and social factors to the course of treatment of depression.
  
  
  METHODS
  The study included 151 patients (finally 140 patients were evaluated) hospitalized for major depressive disorder. They were assessed for demographic characteristics, the rates of depression and anxiety, quality of life, the rates of dissociation and insomnia, and subjective and objective disease severity at different times during treatment. Patients were treated with standard doses of antidepressants or other psychiatric medication. They also completed a 6-week long daily cognitive-behavioural therapy. Data were statistically analyzed.
  
  
  RESULTS
  There were significant decreases in the overall severity of the disorder, anxiety level and depression rate during treatment. Improvement measured by objective Clinical Global Impression (oCGI-I) at the end of treatment was not significantly correlated with any of the measured parameters (age of patient, onset of illness, duration of disease, doses of medication etc.). It only significantly positively correlated with the initial evaluation of the patient by oCGI. However, the improvement in subjective assessment (using sCGI-I) correlated with many parameters (increased age, later onset of the disease, greater disease severity at baseline in both overall and subjective evaluation of the severity, anxiety and depressive symptomatology). Furthermore, it was negatively correlated with most quality of life parameters, such as H (Home), F (Feelings), L (Leisure), Sr (Social relations) and G (General).
  
  
  CONCLUSIONS
  The results suggest that individual variables, such as the degree of psychopathology, particularly depression and anxiety, most quality of life parameters, higher patient age and age of disorder onset may be associated with poorer subjective response to complex treatment of patients with major depressive disorder.
authors.affiliation: Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Sedlackova
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Prasko
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Klara
authors.initials: K
authors.lastname: Latalova
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Dana
authors.initials: D
authors.lastname: Kamaradova
authors.affiliation: Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic.
authors.forename: Marie
authors.initials: M
authors.lastname: Ociskova
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Grambal
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Sigmundova
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Kasalova
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Snezana
authors.initials: S
authors.lastname: Cakirpaloglu
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index
chemical_list: D000928:Antidepressive Agents