Riihimäki Kirsi, Sintonen Harri, Vuorilehto Maria, Isometsä Erkki
Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland.
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Front Psychiatry. 2023 Mar 27;14:926410. doi: 10.3389/fpsyt.2023.926410. eCollection 2023.
Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients' HRQoL to correspond to the normal range of the general population remains unknown.
The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to diagnose major depressive disorder. HRQoL was measured by the generic 15D instrument at baseline and at 5 years ( = 106, 77% of baseline patients), and compared with the 15D results of an age-standardized general population sample from the Finnish Health 2011 Survey ( = 4,157). Receiver operating characteristic analyses determined the optimal Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) cut-offs for remission, using the 15D score as the construct validator. Remission was defined as the score at which HRQoL reached the general population range (minimum mean - 1 SD). As age may influence HRQoL, patients older and younger than the median 52 years were investigated separately.
For HAMD, the optimal cut-off point score was 8.5, for BDI 10.5, and for BAI 11.5. The differences between the findings of the younger and older patients were small.
Cross-sectional analysis, small number of patients in the cohort.
Depressive primary care patients' HRQoL reaches the normal variation range of the general population when their depression and anxiety scores reach the conventional clinical cut-offs for remission.
抑郁症会损害健康相关生活质量（HRQoL）。缓解是所有抑郁症治疗的核心目标，但抑郁症患者的HRQoL达到一般人群正常范围所需的缓解程度仍不清楚。
万塔初级保健抑郁症研究对一组基于筛查的抑郁症初级保健患者进行了为期5年的前瞻性随访。使用《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈（SCID-I）来诊断重度抑郁症。在基线和5年时（n = 106，占基线患者的77%）使用通用的15D工具测量HRQoL，并与芬兰2011年健康调查中年龄标准化的一般人群样本（n = 4157）的15D结果进行比较。采用接受者操作特征分析，以15D分数作为结构验证指标，确定汉密尔顿抑郁量表（HAMD）、贝克抑郁量表（BDI）和贝克焦虑量表（BAI）缓解的最佳临界值。缓解定义为HRQoL达到一般人群范围时的分数（最小均值-1标准差）。由于年龄可能影响HRQoL，因此分别对年龄大于和小于中位数52岁的患者进行了调查。
对于HAMD，最佳临界值分数为8.5，BDI为10.5，BAI为11.5。年轻患者和老年患者的研究结果差异较小。
横断面分析，队列中的患者数量较少。
当抑郁症初级保健患者的抑郁和焦虑评分达到传统的临床缓解临界值时，其HRQoL达到一般人群正常变异范围。
