Woo Jong-Min, Jeon Hong Jin, Noh Eunsun, Kim Hyo-Jin, Lee Sun Woo, Lee Kyung Kyu, Kim Sung Hwan, Hong Jin Pyo
Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea.
Stress Research Institute, Inje University, Seoul, Korea.
Health Qual Life Outcomes. 2014 Dec 18;12:188. doi: 10.1186/s12955-014-0188-y.
Major depressive disorder (MDD) is strongly associated with an impaired quality of life (QoL), which is itself affected by various factors. Symptom-oriented ratings poorly reflect the impact of disease on the QoL and level of functioning of the mental health of subjects. The purpose of this study was to assess health-related QoL (HRQoL) using preference-based measures in outpatients with MDD with regard to their remission achievement and clinical factors affecting the HRQoL.
This was a cross-sectional observational study. We recruited 811 patients with MDD from 14 psychiatric outpatient clinics in Korea. They were divided into three groups as follows: a new visit group (n = 287), a remitted group (n = 235), and a non-remitted group (n = 289). The 17-item Hamilton Depression Rating Scale was used to assign patients to the remitted or non-remitted group. The general HRQoL was assessed with the EuroQol 5D (EQ-5D), using both the EQ-5D index score and the EuroQol Visual Analog Scale (EQ-VAS). The disease-specific HRQoL was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF).
The non-remitted group showed a significant impairment of HRQoL in view of the subscales of EQ-5D index scores, EQ-VAS, and Q-LES-Q-SF. The EQ-5D index score in the remitted group was 0.77 ± 0.10, while it was 0.57 ± 0.23 in the non-remitted group and 0.58 ± 0.24 in the new visit group (p < 0.0001). The EQ-VAS scores for the remitted and non-remitted groups were 72.5 ± 16.6 and 50.9 ± 20.3, respectively (p < 0.0001). Likewise, patients with remission had the Q-LES-Q-SF total score of 46.5 ± 8.8, whereas those with non-remission reported 36.7 ± 7.7 (p < 0.0001). The symptom severity measured by the Depression and Somatic Symptoms Scale was significantly correlated with the HRQoL. Furthermore, patients with severe somatic symptoms showed a significantly lower EQ-5D index score (0.54 ± 0.24) than those with mild/moderate somatic symptoms (0.75 ± 0.12; p = 0.002).
Non-remitted MDD patients, especially those with more severe somatic symptoms, show a distinct impairment of HRQoL and more clinical symptoms, suggesting the importance of achieving remission in the treatment of MDD.
重度抑郁症（MDD）与生活质量（QoL）受损密切相关，而生活质量本身又受多种因素影响。以症状为导向的评分不能很好地反映疾病对患者生活质量和心理健康功能水平的影响。本研究旨在使用基于偏好的测量方法评估MDD门诊患者的健康相关生活质量（HRQoL），以及其缓解情况和影响HRQoL的临床因素。
这是一项横断面观察性研究。我们从韩国14家精神科门诊招募了811例MDD患者。他们被分为三组：初诊组（n = 287）、缓解组（n = 235）和未缓解组（n = 289）。使用17项汉密尔顿抑郁量表将患者分为缓解组或未缓解组。使用欧洲五维健康量表（EQ-5D）评估总体HRQoL，包括EQ-5D指数得分和欧洲五维视觉模拟量表（EQ-VAS）。使用生活享受与满意度问卷简表（Q-LES-Q-SF）评估特定疾病的HRQoL。
从未缓解组在EQ-5D指数得分、EQ-VAS和Q-LES-Q-SF的子量表方面显示出HRQoL的显著受损。缓解组的EQ-5D指数得分为0.77±0.10，未缓解组为0.57±0.23，初诊组为0.58±0.24（p < 0.0001）。缓解组和未缓解组的EQ-VAS得分分别为72.5±16.6和50.9±20.3（p < 0.0001）。同样，缓解患者的Q-LES-Q-SF总分是46.5±8.8，而未缓解患者报告的分数为36.7±7.7（p < 0.0001）。抑郁和躯体症状量表测量的症状严重程度与HRQoL显著相关。此外，有严重躯体症状的患者的EQ-5D指数得分（0.54±0.24）显著低于有轻度/中度躯体症状的患者（0.75±0.12；p = 0.002）。
未缓解的MDD患者，尤其是那些有更严重躯体症状的患者，表现出明显的HRQoL受损和更多临床症状，这表明在MDD治疗中实现缓解的重要性。
