Introduction
Depression causes a significant number of years of life lost due to disability in Thailand, and ranks behind only cardiovascular disorder, human immunodeficiency virus/acquired immunodeficiency syndrome, and diabetes mellitus on the disability-adjusted life year index (1999–2004).1 The Epidemiology of Mental Disorders National Survey in 2008 found major depressive disorder (MDD) in 3.2% of the Thai population, while 0.3% were found to have dysthymia (double depression was not reported).2 Despite the serious impact this disorder can have, no study has ever been published, to the authors’ knowledge, regarding treatment outcomes. Psychosocial factors usually play an important role in relation to depression, either as predisposing or precipitating