Kuehner Christine, Buerger Christin
Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, P.O. Box 122120, 68072 Mannheim, Germany.
J Affect Disord. 2005 Jun;86(2-3):205-13. doi: 10.1016/j.jad.2005.01.014.
We aimed to assess the subjective quality of life (QOL) in depressed patients after discharge from inpatient treatment and to investigate the net impact of self-related constructs (self-esteem, response styles to depressed mood) and of social support on specific subjective QOL domains.
Four weeks after discharge from inpatient treatment, 89 unipolar depressed patients were assessed with a comprehensive battery of psychopathology and psychosocial measures. Subjective QOL was assessed using the World Health Organization Quality of Life Scale (WHOQOL-BREF). Analyses included hierarchical regressions.
Non-remitted patients reported poorer subjective QOL than fully and partially remitted patients regarding physical and psychological health, and overall QOL. After adjusting for demographic and clinical history variables, interviewer-rated severity of depression accounted for 4% to 36% of the variance in individual QOL domain scores. Self-esteem, rumination, distraction and the existence of a partnership added further increments to the explained variance of the psychological QOL domain. Rumination, partnership, and network size of family members providing psychological crisis support also predicted subjective QOL on the social relations domain.
Our results suggest that self-esteem, response styles to depressed mood, and social support characteristics contribute substantially to the psychological and social domains of subjective QOL in depressed patients. These associations are not attributable to concurrent symptom severity. Therapy with depressed patients should not only focus on symptom reduction but should help the patients to establish and maintain supportive relationships and to enhance self-appreciation and skills to cope with negative mood in order to improve psychological well-being and health-related quality of life.
我们旨在评估住院治疗后出院的抑郁症患者的主观生活质量（QOL），并调查自我相关构念（自尊、对抑郁情绪的应对方式）和社会支持对特定主观生活质量领域的净影响。
在住院治疗出院四周后，对89名单相抑郁症患者进行了一系列全面的精神病理学和心理社会测量。使用世界卫生组织生活质量量表（WHOQOL-BREF）评估主观生活质量。分析包括分层回归。
在身体健康、心理健康和总体生活质量方面，未缓解的患者报告的主观生活质量比完全缓解和部分缓解的患者差。在调整了人口统计学和临床病史变量后，访谈者评定的抑郁严重程度占个体生活质量领域得分方差的4%至36%。自尊、沉思、分心以及是否有伴侣关系进一步增加了心理生活质量领域的解释方差。沉思、伴侣关系以及提供心理危机支持的家庭成员网络规模也预测了社会关系领域的主观生活质量。
我们的结果表明，自尊、对抑郁情绪的应对方式和社会支持特征对抑郁症患者主观生活质量的心理和社会领域有重大贡献。这些关联并非归因于同时存在的症状严重程度。对抑郁症患者的治疗不仅应关注症状减轻，还应帮助患者建立和维持支持性人际关系，增强自我欣赏和应对负面情绪的技能，以改善心理健康和与健康相关的生活质量。
