Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan.
Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
Value Health Reg Issues. 2022 Jul;30:127-133. doi: 10.1016/j.vhri.2021.12.001. Epub 2022 Apr 9.
Major depressive disorder (MDD) is increasing worldwide and is associated with impaired quality of life (QOL). This study aimed to assess the QOL and its association with cognitive symptoms in patients with MDD who started antidepressant monotherapy.
Data from the PERFORM (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder) study were analyzed. A descriptive epidemiological analysis on EQ-5D-5L utility score, the level of each dimension, and the EuroQoL visual analog scale value was conducted at 4 visits during 6 months' follow-up. The association between cognitive complaints and changes in QOL measures was analyzed using multivariate linear regression analysis.
The median EQ-5D-5L utility score improved from 0.67 at baseline to 0.82 at month 6. Although the proportion of patients reporting level 1 (no problem) in every dimension of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression increased over time, less than half of the patients achieved level 1 in pain/discomfort and depression/anxiety, which were closely related to depression and usual activities at month 6. Patients with no cognitive complaints or no history of MDD at baseline showed greater improvement in EQ-5D-5L utility scores and EuroQoL visual analog scale value for measuring QOL than those with these characteristics.
Treatment over 6 months improved QOL in patients with MDD although there remained room for improvement in dimensions of usual activities, pain/discomfort, and depression/anxiety. Cognitive complaints or history of MDD at baseline predicted less improvement in QOL at 6 months. Any history of MDD might delay improvement in QOL after treatment.
重度抑郁症（MDD）在全球范围内呈上升趋势，与生活质量（QOL）受损有关。本研究旨在评估开始抗抑郁单药治疗的 MDD 患者的 QOL 及其与认知症状的关系。
对 PERFORM（与重度抑郁症相关的功能结局的前瞻性流行病学研究）研究的数据进行了分析。在 6 个月的随访期间的 4 次就诊中，对 EQ-5D-5L 效用评分、每个维度的水平以及 EuroQoL 视觉模拟量表值进行描述性流行病学分析。使用多元线性回归分析来分析认知症状与 QOL 测量变化之间的关系。
EQ-5D-5L 效用评分中位数从基线时的 0.67 改善至 6 个月时的 0.82。尽管报告在移动、自理、日常活动、疼痛/不适和焦虑/抑郁各维度均为 1 级（无问题）的患者比例随着时间的推移而增加，但仍不到一半的患者在疼痛/不适和抑郁/焦虑方面达到 1 级，这些症状与抑郁和 6 个月时的日常活动密切相关。基线时无认知症状或无 MDD 病史的患者在 EQ-5D-5L 效用评分和 QOL 测量的 EuroQoL 视觉模拟量表值方面的改善程度大于具有这些特征的患者。
尽管在日常活动、疼痛/不适和抑郁/焦虑方面仍有改善空间，但治疗 6 个月可改善 MDD 患者的 QOL。基线时的认知症状或 MDD 病史预测 6 个月时 QOL 改善程度较低。任何 MDD 病史都可能会延迟治疗后 QOL 的改善。
