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重度抑郁症患者生活质量变化的预测因素——一项前瞻性自然主义3个月随访研究

Predictors of Changes in Quality of Life of Patients with Major Depressive Disorder-A Prospective Naturalistic 3-Month Follow-Up Study.

作者信息

Dionisie Vlad, Puiu Maria Gabriela, Manea Mirela, Pacearcă Ioana Anca

机构信息

Department of Psychiatry and Psychology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

"Prof. Dr. Alexandru Obregia" Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.

出版信息

J Clin Med. 2023 Jul 12;12(14):4628. doi: 10.3390/jcm12144628.

Abstract

Major depressive disorder (MDD) is one of the leading causes of disease burden worldwide and affected patients frequently report impairments in quality of life (QoL). Therefore, the present research aimed to identify predictors of domain-specific QoL changes in MDD patients following the acute phase of pharmacological treatment (3-month). This study is a prospective, naturalistic, and observational analysis on 150 patients. Depressive symptoms, QoL, overall pain intensity, and functionality were assessed using Hamilton Depression Rating Scale, World Health Organization Quality of Life scale-abbreviated version, Visual Analog Scale, and Sheehan Disability Scale, respectively. Reductions in symptom severity and disability were predictors of improvement across all domains of QoL. Pain intensity reduction was a predictor of increases in the physical aspect of QoL. A reduced number of psychiatric hospitalizations and being in a relationship predicted an improvement of QoL in the psychological domain whereas a positive history of suicidal attempts was associated with better social relationships QoL. The predictive models explained 41.2% and 54.7% of the variance in psychological and physical health domains of QoL, respectively. Awareness of sociodemographic and changes in clinical factors that impact the change in domain-specific QoL might help in shaping personalized treatment.

摘要

重度抑郁症(MDD)是全球疾病负担的主要原因之一,受影响的患者经常报告生活质量(QoL)受损。因此,本研究旨在确定药物治疗急性期(3个月)后MDD患者特定领域QoL变化的预测因素。本研究是一项对150名患者进行的前瞻性、自然主义和观察性分析。分别使用汉密尔顿抑郁量表、世界卫生组织生活质量量表简版、视觉模拟量表和希恩残疾量表评估抑郁症状、QoL、总体疼痛强度和功能。症状严重程度和残疾程度的降低是QoL所有领域改善的预测因素。疼痛强度的降低是QoL身体方面改善的预测因素。精神科住院次数减少和处于恋爱关系中预示着心理领域QoL的改善,而自杀未遂的阳性史与更好的社会关系QoL相关。预测模型分别解释了QoL心理和身体健康领域41.2%和54.7%的方差。了解影响特定领域QoL变化的社会人口学和临床因素变化可能有助于制定个性化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7558/10380991/5af50036e282/jcm-12-04628-g001.jpg

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