Greta Šalčiūtė, Dovylė Žiupsnienė, Kazys Simanauskas, Vytautas Kasiulevičius, Virginijus Šapoka
The aim of this study was to determine the impact of chronic diseases for depressive episodes. Material and methods: Primary health care center has carried out a placement of immediate retrospective study of outpatients with patients selected according to ICD-10 for the three digit from 31.3 F to 33.9 F. We examined the possibility of a connection between chronic diseases and depression in a view of the emergence of depressive illness period, considering the effectiveness of the methods of treatment and the progress of somatic symptom onset. The data obtained were processed by statistical program SPSS 18.104.22.168. Results: 234 outpatient data were selected for the research work. Patient age ranged from 25 to 89 years, while 60,6 percent, most of the participants, were women. It was found that 70,7 percent of patients were diagnosed with a major depressive disorder and in 28,6 percent of the cases it occurred repeatedly and most of the patients had moderate depression (n=203). After combining the obtained data it was estimated that 51,28 percent of the patients identified chronic disease as the cause of depression occurrence. The majority of the selected patients prevailed in essential hypertension (47,86 percent), oncological (19,23 percent), vertebral pathology (17,52 percent), osteoarthritis (14,53 percent), thyroid disease (14,10 percent). Based on the calculation we can reliably say that the diagnosis of oncological disease trigger depression (χ2=24.525; p=0,001), which was most frequently localized as the uterine and breast malignancies (n=11 and 10). Bone pathology as the cause of depression identified 50 (66,7 percent) participants. The analysis showed that these patients may develop depression (χ2=10.457; p=0,001). Meanwhile, the pain syndrome accompanied some chronic diseases (mainly osteochondroma and radiculopathy (58,75 percent), osteoarthritis (31,25 percent), cancer (16,25 percent), which was the reason why 70 percent of these patients identified pain as the cause of depression. Meanwhile, these chronic conditions did not relate to the diagnosis of depression associated with the thyroid (p=0,731), cardiovascular (p=0,045), nervous system (p=0,256), chronic pulmonary disease (p=0,803), and diabetes (p=0,706). Conclusion: It was estimated that more than two thirds of the respondents who are suffering from 1-2 chronic diseases have a reasonably high probability of having/getting a depression as well (χ2=12.828; p=0,002). The carried out analysis revealed that almost a half of the patients with permanent depressive state attacks (n=118) were mainly with somatic symptoms of deterioration (n=29,06). Estimates show that more than 60 percent of all cases where connected with the treatment with continuous progress, although one-third of them modified due to the lack of effect of the product. Although when the depression diagnosis was confirmed most of the observed were already patients of at least one chronic disease, there was no increase in depressive episodes. Oncological diseases, spine and joint pathology mediated by pain syndrome may be associated with the occurence of the depression. Age and gender are irrelevant for depressive episodes, although the number of chronic diseases may be associated with the occurence of depressive illness. The clinical expression of the somatic depression is not typical for the patients of chronic diseases. The continuity of the treatment strategy by changing the appointment of pharmaceuticals is a possible cause of a fluctuating process of depression which tends to express the positive dynamics of the condition.
Keyword(s): chronic diseases; depression; connection; cause; primary care
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