Several studies have demonstrated that Mood Disorders are threatening, widespread disorders characterized by poor outcome and chronic development. This study was undertaken to examine the features of affective patients in long-term residential care.
The study group consisted of 162 patients with a principal diagnosis of Major Depression (MDD), Bipolar Disorder I (BD-I) or Dysthymic Disorder (Dy), according to DSM IV criteria, assessed by the SCID I and II. Patients were also assessed with the HAM-D, the YMRS, the DDERS and the GAF. Current and prior medical health problems were documented also using the CIRS.
The most frequent diagnosis in our sample was found to be MDD (50.6%), followed by BD-I (35.8%) and Dy (13.6%). Psychotic symptoms were detected in 12.9% of the patients. MDD presented the higher level of depressive symptoms followed by BD-I and Dy. The latter showed the longer duration of illness and the longer untreated period compared with those of BD-I and MDD, and also presented the greater number of comorbid conditions, both medical and psychiatric. In addiction, the mean CIRS severity index for Dysthymia was significantly higher than that of MDD and BD-I. All affective patients showed a low level of global functioning, with no significant differences between the three diagnostic groups.
Affective patients in long-term residential facilities show significant impairment probably due to the complexity and severity of the psychopathology and in particular to the high rates of comorbidity, thus calling for a greater awareness in diagnosing and treating these patients in a residential setting.