Demyttenaere Koen, Andersen Henning Friis, Reines Elin Heldbo
Department of Psychiatry, University Hospital Gasthuisberg, Herestraat 49, Leuven, Belgium.
Int Clin Psychopharmacol. 2008 Sep;23(5):276-86. doi: 10.1097/YIC.0b013e328303ac5f.
Administration of the same Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) in major depressive disorder (MDD) and in generalized anxiety disorder (GAD) before and after treatment allowed us to compare quality of life enjoyment and satisfaction in these two disorders and to compare outcome based on symptoms versus functioning. Q-LES-Q and symptom-specific Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Scale (HAMA) data from eight randomized, 8-week, double-blind, placebo-controlled clinical trials with escitalopram were used. MDD (n=1,140) or GAD (n=1,045) patients report a substantial degree of quality of life enjoyment and satisfaction impairment (baseline scores 64% and 76% of community norm, respectively). Treatment resulted in statistically and clinically significant improvement in quality of life enjoyment and satisfaction. The improvement was greater in patients treated with escitalopram than with placebo. In MDD, the majority of remitters (MADRS<or=12) reached 'normal' quality of life enjoyment and satisfaction levels, whereas in GAD, 67% of remitters (HAMA<or=7) reached 'normal' quality of life, enjoyment, and satisfaction. A strong correlation between the symptom-specific scales and the Q-LES-Q was observed. These analyses suggest that remission with scores of 6 on the MADRS and 5 on the HAMA correspond with a quality of life enjoyment and satisfaction found in community comparison patients (Q-LES-Q score of 58+/-10%). Treatment with escitalopram results in a significant improvement of quality of life enjoyment and satisfaction in patients with MDD or GAD. Both response and remission in patients with GAD and remission in patients with MDD are correlated with a 'normal' quality of life enjoyment and satisfaction.
在重度抑郁症(MDD)和广泛性焦虑症(GAD)患者治疗前后使用相同的生活质量享受与满意度问卷(Q-LES-Q),使我们能够比较这两种疾病的生活质量享受与满意度,并基于症状与功能来比较治疗结果。使用了来自八项随机、为期8周、双盲、安慰剂对照的艾司西酞普兰临床试验的Q-LES-Q以及症状特异性的蒙哥马利-艾斯伯格抑郁评定量表(MADRS)和汉密尔顿焦虑量表(HAMA)数据。MDD患者(n = 1140)或GAD患者(n = 1045)报告生活质量享受与满意度有相当程度的受损(基线分数分别为社区常模的64%和76%)。治疗使生活质量享受与满意度在统计学和临床上都有显著改善。接受艾司西酞普兰治疗的患者改善程度大于接受安慰剂治疗的患者。在MDD中,大多数缓解者(MADRS≤12)达到了“正常”的生活质量享受与满意度水平,而在GAD中,67%的缓解者(HAMA≤7)达到了“正常”的生活质量、享受与满意度。观察到症状特异性量表与Q-LES-Q之间有很强的相关性。这些分析表明,MADRS评分为6分且HAMA评分为5分的缓解与社区对照患者的生活质量享受与满意度相符(Q-LES-Q评分为58±10%)。艾司西酞普兰治疗可使MDD或GAD患者的生活质量享受与满意度显著改善。GAD患者的反应和缓解以及MDD患者的缓解都与“正常”的生活质量享受与满意度相关。