Daly Ella J, Trivedi Madhukar H, Wisniewski Stephen R, Nierenberg Andrew A, Gaynes Bradley N, Warden Diane, Morris David W, Luther James F, Farabaugh Amy, Cook Ian, Rush A John
Department of Psychiatry, University of Texas Southwestern Medical School at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA.
Ann Clin Psychiatry. 2010 Feb;22(1):43-55.
Although major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQOL), few studies have evaluated HRQOL dysfunction in multiple domains. This report examined the psychological, physical, and social domains in a large sample of outpatients who entered the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.
The relationship of HRQOL and baseline sociodemographic and clinical features, including depressive severity, was evaluated. We assessed HRQOL with the 12-item Short Form Health Survey, the 5-item Work and Social Adjustment Scale, and the 16-item Quality of Life Enjoyment and Satisfaction Questionnaire.
Among 2307 participants, greater depressive symptom severity was associated with poorer HRQOL. After controlling for age and depression severity, lower HRQOL was related independently to being African American or Hispanic, less educated, unemployed, divorced or separated, having public medical insurance, and to having more general medical disorders. We found impairments across all 3 domains, with low correlations between the 3 measures of HRQOL chosen, suggesting that they evaluate different and nonoverlapping aspects of function.
Sociodemographically disadvantaged patients with greater general medical and depressive illness burden are at greatest risk for poorer quality of life. Distinct impairments are seen in the 3 domains of HRQOL.
尽管重度抑郁症（MDD）与健康相关生活质量（HRQOL）的显著损害有关，但很少有研究评估多个领域的HRQOL功能障碍。本报告在进入缓解抑郁的序贯治疗方案（STAR*D）试验的大量门诊患者样本中，对心理、身体和社会领域进行了研究。
评估了HRQOL与基线社会人口统计学和临床特征（包括抑郁严重程度）之间的关系。我们使用12项简短健康调查问卷、5项工作和社会适应量表以及16项生活质量享受与满意度问卷来评估HRQOL。
在2307名参与者中，抑郁症状越严重，HRQOL越差。在控制年龄和抑郁严重程度后，较低的HRQOL独立地与非裔美国人或西班牙裔、受教育程度较低、失业、离婚或分居、拥有公共医疗保险以及患有更多的一般躯体疾病有关。我们发现所有三个领域均存在损害，所选的三种HRQOL测量方法之间的相关性较低，这表明它们评估的是功能的不同且不重叠的方面。
在社会人口统计学上处于不利地位且有更大的一般躯体疾病和抑郁疾病负担的患者，生活质量较差的风险最大。在HRQOL的三个领域中都发现了明显的损害。
