Major Depression: A Short Term Naturalistic Study in Outpatients

Background: Surprisingly data regarding naturalistic or observational studies carried out in India to study Major Depressive Disorder in patients seeking outpatient treatment is almost non-existing. So this study was conducted to study the presentation and baseline characteristics of Major Depressive Disorder in Indian outpatients and the subsequent treatment and outcome after a three month follow up. Methodology: Patients seeking outpatient treatment were recruited after diagnosing an episode of Major Depressive Disorder through a clinical interview for DSM IV TR. Sociodemographic and clinical characteristics were recorded at the time of recruitment and follow up evaluations done for 3 months. All the patients were given outpatient treatment best suited to the patient profile. Results :.More than 90% patients reported one or more somatic symptoms spontaneously on presentation . Barely half of the patients out of 119 recruited completed three month follow up. 50 (81%) patients out of 62 who received adequate treatment met recovery criteria at the end of three months. Initial depression severity and receiving regular adequate antidepressant therapy was found to be associated with recovery. While sociodemographic variables were not found to significantly affect treatment outcome or compliance. Conclusion : Somatic presentation of depression is quite common in Indian patients .The high noncompliance indicate the need for strategies to be made to improve compliance and the good response to treatment found in naturalistic conditions in this study calls for more such studies to be done for better understanding of predictors of outcome in naturalistic conditions in India.