Prevalence and Associated Factors of Non-Responder Depression in The First Treatment of Adult Patients at Samutprakarn Hospital
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Abstract
Objective: To investigate the prevalence of non-responder depression and the association between the factors and the non-responder depression in the first treatment of adult patients at Samutprakarn hospital.
Methods: This is a retrospective descriptive study which collected data from adult patients aged ≥18 years who were newly diagnosed with major depressive disorder by psychiatrists in the outpatient psychiatric and substance abuse clinic at Samutprakarn hospital. The study covered the period from October 2022 to April 2024 and included patients who continued to follow up with treatment consistently. The 9-item Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression both before and during treatment to monitor the response to treatment. The non-responder group was defined as patients whose scores decreased by less than 50 % from their baseline scores, despite receiving an adequate dose of the initial antidepressant within a 12-week period. Pearson’s chi-square test, Fisher’s exact test, Independent t-test and Logistic regression model were used to determine the association between different clinical variables.
Results: This study included a total of 159 participants. Among them, 99 patients (62.24%) with depression responded to treatment, while 60 patients (37.74%) did not. In the non-responsive group, higher proportions of female were observed (p-value = 0.011), along with a younger age (p-value = 0.010), greater chronicity of stressors (p-value < 0.001), higher history of hospital admissions for depression as the primary diagnosis (p-value = 0.032), more outpatient follow-up visits during the first six months (p-value < 0.001), and more medication prescriptions including second-generation antipsychotics and mood stabilizers (p-value = 0.008 and p-value < 0.001 respectively). In addition, the group showed lower medication adherence (p-value = 0.003). In the logistic regression model, comorbid anxiety disorders and being married were associated with non-responsive group (p-value = 0.033 and p-value = 0.039 respectively)
Conclusion: The prevalence of non-responder depression in this study was 37.74%. Factors associated with non-response to initial treatment for depression included age, gender, marital status, comorbid anxiety disorders, history of hospital admissions, frequency of outpatient visits, medical adherence, and certain prescribed medications. Many of these factors are modifiable and can be addressed through preventive measures and improvements in the healthcare system to enhance the effectiveness of care for the patients.
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