Factors Associated With Health-Related Quality of Life Among Outpatients With Major Depressive Disorder: A STAR*D Report.
J Clin Psychiatry 2006;67(2):185-195
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Objective: Major depressive disorder
(MDD) is often chronic and is often associated with
significant morbidity and mortality. The
importance of assessing disability and health-related
quality of life (HRQOL) in patients with MDD has
only recently been recognized. The aim of this
study was to examine sociodemographic and clinical correlates of HRQOL in a large cohort of
outpatients with MDD.
Method: Baseline assessments were
completed for 1500 consecutive patients enrolled
in the Sequenced Treatment Alternatives to Relieve Depression trial, including
sociodemographic characteristics and measures of depressive
symptom severity, clinical features, and HRQOL.
Multiple domains of HRQOL were assessed with the 12-item Short Form Health Survey, the Work
and Social Adjustment Scale, and the Quality of
Life Enjoyment and Satisfaction Questionnaire. The current analyses were conducted on HRQOL
data available for 1397 of the 1500 subjects.
Results: Greater symptom severity was
associated with reduced HRQOL by all measures.
Even after age and symptom severity were
controlled for, a number of clinical features and
sociodemographic characteristics were independently
associated with HRQOL in multiple domains, including age at onset of MDD, ethnicity, marital
status, employment status, education level,
insurance status, and monthly household income.
Conclusion: Results strongly suggest the
need to assess HRQOL in addition to symptoms in order to gauge the true severity of MDD. This
study also highlights the necessity of measuring HRQOL in multiple domains. These results
have implications for the assessment of remission
and functional recovery in the treatment of MDD.