title: The impact of residual symptoms on relapse and quality of life among Thai depressive patients.
abstract: OBJECTIVE
  Residual symptoms of depressive disorder are major predictors of relapse of depression and lower quality of life. This study aims to investigate the prevalence of residual symptoms, relapse rates, and quality of life among patients with depressive disorder.
  
  
  METHODS
  Data were collected during the Thai Study of Affective Disorder (THAISAD) project. The Hamilton Rating Scale for Depression (HAMD) was used to measure the severity and residual symptoms of depression, and EQ-5D instrument was used to measure the quality of life. Demographic and clinical data at the baseline were described by mean ± standard deviation (SD). Prevalence of residual symptoms of depression was determined and presented as percentage. Regression analysis was utilized to predict relapse and patients' quality of life at 6 months postbaseline.
  
  
  RESULTS
  A total of 224 depressive disorder patients were recruited. Most of the patients (93.3%) had at least one residual symptom, and the most common was anxiety symptoms (76.3%; 95% confidence interval [CI], 0.71-0.82). After 3 months postbaseline, 114 patients (50.9%) were in remission and within 6 months, 44 of them (38.6%) relapsed. Regression analysis showed that residual insomnia symptoms were significantly associated with these relapse cases (odds ratio [OR] =5.290, 95% CI, 1.42-19.76). Regarding quality of life, residual core mood and insomnia significantly predicted the EQ-5D scores at 6 months postbaseline (B =-2.670, 95% CI, -0.181 to -0.027 and B =-3.109, 95% CI, -0.172 to -0.038, respectively).
  
  
  CONCLUSIONS
  Residual symptoms are common in patients receiving treatment for depressive disorder and were found to be associated with relapses and quality of life. Clinicians need to be aware of these residual symptoms when carrying out follow-up treatment in patients with depressive disorder, so that prompt action can be taken to mitigate the risk of relapse.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok.
authors.forename: Thanita
authors.initials: T
authors.lastname: Hiranyatheb
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok.
authors.forename: Daochompu
authors.initials: D
authors.lastname: Nakawiro
authors.affiliation: Department of Psychiatry, Faculty of Medicine.
authors.forename: Tinakon
authors.initials: T
authors.lastname: Wongpakaran
authors.affiliation: Department of Psychiatry, Faculty of Medicine.
authors.forename: Nahathai
authors.initials: N
authors.lastname: Wongpakaran
authors.affiliation: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai.
authors.forename: Putipong
authors.initials: P
authors.lastname: Bookkamana
authors.affiliation: Department of Psychiatry, Faculty of Medicine.
authors.forename: Manee
authors.initials: M
authors.lastname: Pinyopornpanish
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.
authors.forename: Nattha
authors.initials: N
authors.lastname: Saisavoey
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.
authors.forename: Kamonporn
authors.initials: K
authors.lastname: Wannarit
authors.affiliation: Department of Psychiatry Khon Kaen Hospital, Khon Kaen.
authors.forename: Sirina
authors.initials: S
authors.lastname: Satthapisit
authors.affiliation: Department of Psychiatry, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.
authors.forename: Sitthinant
authors.initials: S
authors.lastname: Tanchakvaranont
keywords: Thai; depression; quality of life; relapse; residual symptoms; treatment