Karp Jordan F, Skidmore Elizabeth, Lotz Meredith, Lenze Eric, Dew Mary Amanda, Reynolds Charles F
Advanced Center for Intervention and Services Research for Late Life Mood Disorders, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Courier/Office: 100 North Bellefield Avenue, Room 766, Pittsburgh, PA 15213, USA.
J Am Geriatr Soc. 2009 Sep;57(9):1612-9. doi: 10.1111/j.1532-5415.2009.02398.x. Epub 2009 Jul 21.
To determine whether there was greater disability in subjects with depression than in those without, the correlation between disability and depression severity and quality of life, and whether improvement in disability after antidepressant pharmacotherapy was greater in those who responded to antidepressant treatment.
Disability in subjects with and without depression from two different studies was compared for 22 weeks. Correlations were performed for the subjects with depression between disability and depression, anxiety, health-related quality of life (HRQOL), and medical comorbidity. T-tests were used to compare disability between subjects who did and did not respond to antidepressant treatment and change in disability after pharmacotherapy.
Late-life depression research clinic.
The 313 subjects were recruited from primary care and the community and were aged 60 and older; 244 subjects were participants in a depression treatment protocol, and 69 subjects without depression participated in a separate longitudinal observational study of the mental and cognitive health of depression-free older adults.
The Late-Life Function and Disability Instrument (LL-FDI), a measure of instrumental activity of daily living, personal role, and social role functioning.
Subjects with depression scored lower than controls for domains measuring limitation (can do) and frequency (does do) of activities. Both disability domains correlated with depression severity, anxiety, HRQOL, and cognition. Disability improved with antidepressant treatment; for partial responders who continued to receive higher-dose antidepressant treatment out to 22 weeks, there was continued improvement, although not to the level of comparison subjects without depression.
The LL-FDI appears to discriminate subjects with depression from those without, correlates with depression severity, and demonstrates sensitivity to antidepressant treatment response. We recommend further investigation of the LL-FDI and similar disability instruments for assessing depression-related disability.
确定抑郁症患者是否比非抑郁症患者存在更严重的残疾，残疾与抑郁严重程度及生活质量之间的相关性，以及抗抑郁药物治疗后有反应的患者残疾改善情况是否比无反应者更大。
对两项不同研究中患抑郁症和未患抑郁症的受试者的残疾情况进行了22周的比较。对抑郁症患者的残疾与抑郁、焦虑、健康相关生活质量（HRQOL）及合并症之间进行相关性分析。采用t检验比较对抗抑郁治疗有反应和无反应的受试者之间的残疾情况以及药物治疗后残疾的变化。
老年抑郁症研究诊所。
313名受试者从初级保健机构和社区招募，年龄在60岁及以上；244名受试者参与抑郁症治疗方案，69名无抑郁症受试者参与一项关于无抑郁症老年人心理和认知健康的单独纵向观察研究。
采用老年功能与残疾量表（LL-FDI），该量表用于测量日常生活工具性活动、个人角色和社会角色功能。
在测量活动受限（能做）和频率（实际做）的领域，抑郁症患者的得分低于对照组。两个残疾领域均与抑郁严重程度、焦虑、HRQOL及认知相关。抗抑郁治疗后残疾情况有所改善；对于持续接受高剂量抗抑郁治疗至22周的部分反应者，残疾情况持续改善，尽管未达到无抑郁症对照受试者的水平。
LL-FDI似乎能够区分抑郁症患者和非抑郁症患者，与抑郁严重程度相关，并对抗抑郁治疗反应具有敏感性。我们建议进一步研究LL-FDI及类似的残疾量表，以评估与抑郁症相关的残疾情况。
