Mayor morbilidad y uso de servicios médicos en atención primaria en pacientes con trastorno depresivo mayor y sus familiares: un estudio de cohorte retrospectivo

Objective: To study the impact of non-psychiatric medical visits by patients with Major Depressive Disorder (MDD) and their family members, compared to healthy people and their relatives in Primary Care. Design: Retrospective cohort observational study. Location: San Alberto Hurtado Primary Care Clinic, Santiago-Chile. Participants: Patients diagnosed with MDD during 2008 were paired by gender, age, and educational level with 2 healthy controls. We followed-up 206 patients with 310 family members and 412 controls with 588 relatives. Main measurements: During 1 year after the diagnosis, all health visits were assessed in patients and their family members and compared with healthy controls and their relatives. For statistical analysis we used U-Mann-Whitney, considering statistical significance with p values ≤0.05. Results: The relative risk of making a non-psychiatric medical visit in depressed patients was 1.43 (95% CI: 1.19-1.67) and in their family members was 1.37 (95% CI: 1.16-1.58). The most frequent health complaints in patients were trauma, respiratory, and neurological problems. Family members visited physicians due trauma, psychiatric and endocrinological complaints. Conclusions: The patients with MDD and their family members have a higher rate of medical visits in Primary Care. A family-oriented treatment of these patients could improve clinical outcomes and reduce the patient overload in this setting.