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Original Research

Health-Related Quality-of-Life Measure Enhances Acute Treatment Response Prediction in Depressed Inpatients

Jeffrey M. Pyne, Dale Bullock, Robert M. Kaplan, Thomas L. Smith, J. Christian Gillin, Shahrokh Golshan, John R. Kelsoe, and D. Keith Williams

Published: April 1, 2001

Article Abstract

Background: Many nonbiological variables arereported to predict treatment response for major depression;however, there is little agreement about which variables are mostpredictive.

Method: Inpatient subjects (N = 59) diagnosedwith current DSM-IV major depressive disorder completed weeklydepressive symptom ratings with the Hamilton Rating Scale forDepression (HAM-D-17) and Beck Depression Inventory (BDI), andweekly health-related quality-of-life (HRQL) ratings with theQuality of Well-Being Scale (QWB). Acute responders wereidentified by a 50% decrease in HAM-D-17 score from baselinewithin 4 weeks of medication treatment. Predictor variables wereinitially chosen from a literature review and then tested fortheir association with acute treatment response.

Results: An initial predictive modelincluding age at first depression, admission BDI score, andmelancholia predicted acute treatment response with 69% accuracyand was designated as the benchmark model. Adding the admissionQWB index score to the benchmark model did not improve theprediction rate; however, adding the admission QWB subscales forphysical and social activity to the benchmark model significantlyimproved acute treatment response prediction to 86% accuracy (p =.001).

Conclusion: In addition to being designed foruse in cost-effectiveness analyses, the QWB subscales appear tobe useful HRQL variables for predicting acute inpatientdepression treatment response.

Volume: 62

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