Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
J Affect Disord. 2010 Jan;120(1-3):126-32. doi: 10.1016/j.jad.2009.04.026.
In the acute phase major depressive disorder (MDD) is a disabling disease. We compared HRQOL in patients with remitted MDD (rMDD) with a community sample and longitudinally assessed the relation between depressive symptoms and HRQOL in recurrently depressed patients.
We used 12-month data of patients from the Depression Evaluation Longitudinal Therapy Assessment (DELTA) study. HRQOL was assessed with the Medical Outcome Short Form (SF-36). Remission was determined with the Structured Clinical Interview for DSM-IV and depressive symptoms were assessed with the Beck Depression Inventory. Patients' mean SF-36 scores were compared with those of an age- and sex-matched Dutch reference population. The longitudinal relation between levels of SF-36 and levels of depressive symptomatology was assessed with a repeated measures linear regression analysis using the mixed models module.
In patients with rMDD in the remitted phase, especially in women, both physical and mental HRQOL was lower than in a Dutch population sample. An increase in the level of depressive symptoms corresponded to a decrease in all scales of the SF-36.
Also in remitted rMDD patients, especially in women, HRQOL is lower than in the general population which emphasizes that also in this phase of recurrent depression HRQOL deserves attention. Furthermore, in patients with rMDD a higher depressive symptom severity level is associated with a lower HRQOL. These findings imply that residual symptoms should be treated aggressively and HRQOL enhancement therapies should be developed.
在急性期,重度抑郁症(MDD)是一种使人丧失能力的疾病。我们比较了缓解期 MDD(rMDD)患者的 HRQOL 与社区样本,并纵向评估了复发性抑郁患者的抑郁症状与 HRQOL 之间的关系。
我们使用了 DELTA 研究的 12 个月患者数据。HRQOL 使用医疗结局短期形式(SF-36)进行评估。缓解通过 DSM-IV 结构临床访谈确定,抑郁症状使用贝克抑郁量表评估。患者的平均 SF-36 评分与年龄和性别匹配的荷兰参考人群进行比较。使用混合模型模块的重复测量线性回归分析评估 SF-36 水平与抑郁症状水平之间的纵向关系。
在缓解期的 rMDD 患者中,尤其是女性,身体和心理健康的 HRQOL 均低于荷兰人群样本。抑郁症状水平的增加与 SF-36 的所有量表得分的降低相对应。
即使在缓解期的 rMDD 患者中,尤其是女性,HRQOL 也低于一般人群,这强调了即使在复发性抑郁症的这个阶段,HRQOL 也值得关注。此外,rMDD 患者的抑郁症状严重程度越高,HRQOL 越低。这些发现意味着应积极治疗残留症状,并开发 HRQOL 增强疗法。