Dept of Neurology, Philipps-University Marburg, Germany.
Int J Psychiatry Med. 2012;43(1):35-49. doi: 10.2190/PM.43.1.c.
Depressive disorders pose a major challenge to healthcare in the countries of the former Soviet Union. The objective of the current study was to evaluate health-related quality of life (HrQoL) and its determinants in outpatients with major depressive disorder in an urban Russian population.
We consecutively recruited 100 urban Russian outpatients with major depression and 100 non-depressed controls who were matched for age and sex. The severity of their depression was assessed using the Hamilton Depression Rating Scale (HDRS). HrQoL was evaluated using the EuroQol (the EQ-5D and the visual analogue scale, EQ VAS). Independent determinants of HrQoL were identified using multiple regression analysis.
The mean EQ VAS score was 43.0 +/- 27.4 in patients with depression compared to 81.4 +/- 14.7 in the controls (p < 0.01). Out of the domains of the EQ-5D, "anxiety/depression," "usual activities," and "self-care" were the most impaired. Independent determinants of reduced HrQoL were: severity of depression according to the HDRS; violent suicide attempts; suicide attempts in the past; and drug addiction.
HrQoL is considerably reduced in Russians with major depression. The disease-specific patterns of HrQoL impairment and the independent determinants of HrQoL identified in our study could be addressed in focused healthcare programs and clinical trials. Comorbid drug addiction as a determinant of HrQoL should receive greater attention in the management of depressive disorders in urban Russian populations.
抑郁障碍对前苏联国家的医疗保健构成了重大挑战。本研究旨在评估城市俄罗斯人群中重度抑郁症门诊患者的健康相关生活质量(HrQoL)及其决定因素。
我们连续招募了 100 名患有重度抑郁症的城市俄罗斯门诊患者和 100 名年龄和性别匹配的非抑郁对照者。使用汉密尔顿抑郁评定量表(HDRS)评估他们的抑郁严重程度。使用 EuroQol(EQ-5D 和视觉模拟量表,EQ VAS)评估 HrQoL。使用多元回归分析确定 HrQoL 的独立决定因素。
与对照组(81.4 +/- 14.7)相比,抑郁患者的平均 EQ VAS 评分(43.0 +/- 27.4)较低(p < 0.01)。在 EQ-5D 的各个领域中,“焦虑/抑郁”、“日常活动”和“自我护理”是最受影响的。HrQoL 降低的独立决定因素是:根据 HDRS 评估的抑郁严重程度;暴力自杀企图;过去的自杀企图;和药物成瘾。
俄罗斯患有重度抑郁症的患者的 HrQoL 大大降低。我们在研究中确定的 HrQoL 受损的疾病特异性模式和 HrQoL 的独立决定因素,可以在重点医疗保健计划和临床试验中得到解决。药物成瘾作为 HrQoL 的决定因素,应在城市俄罗斯人群抑郁障碍的管理中得到更多关注。