Abstract
Purpose
Major depressive disorder (MDD) negatively impacts different aspects of an individual’s life leading to grave impairments
in quality of life (QOL). We performed a detailed analysis of the interaction between depressive symptom severity, functioning,
and QOL in outpatients with MDD in order to better understand QOL impairments in MDD.
in quality of life (QOL). We performed a detailed analysis of the interaction between depressive symptom severity, functioning,
and QOL in outpatients with MDD in order to better understand QOL impairments in MDD.
Methods
This cross-sectional study was conducted with 319 consecutive outpatients seeking treatment for DSM-IV-diagnosed MDD at an
urban hospital-based outpatient clinic from 2005 to 2008 as part of the Cedars-Sinai Psychiatric Treatment Outcome Registry,
a prospective cohort study of clinical, functioning, and patient-reported QOL outcomes in psychiatric disorders using a measurement-based
care model. This model utilizes the following measures: (a) Depressive symptom severity: Quick Inventory of Depressive Symptomatology-Self
Report (QIDS-SR); (b) Functioning measures: Global Assessment of Functioning (GAF), Sheehan Disability Scale (SDS), Work and
Social Adjustment Scale, and the Endicott Work Productivity Scale; and (c) Quality of Life measure: Quality of Life, Enjoyment,
and Satisfaction Questionnaire—Short Form (Q-LES-Q).
urban hospital-based outpatient clinic from 2005 to 2008 as part of the Cedars-Sinai Psychiatric Treatment Outcome Registry,
a prospective cohort study of clinical, functioning, and patient-reported QOL outcomes in psychiatric disorders using a measurement-based
care model. This model utilizes the following measures: (a) Depressive symptom severity: Quick Inventory of Depressive Symptomatology-Self
Report (QIDS-SR); (b) Functioning measures: Global Assessment of Functioning (GAF), Sheehan Disability Scale (SDS), Work and
Social Adjustment Scale, and the Endicott Work Productivity Scale; and (c) Quality of Life measure: Quality of Life, Enjoyment,
and Satisfaction Questionnaire—Short Form (Q-LES-Q).
Results
QOL is significantly impaired in MDD, with a mean Q-LES-Q score for this study population of 39.8 % (SD = 16.9), whereas the
community norm average is 78.3 %. Regression modeling suggested that depressive symptom severity, functioning/disability,
and age all significantly contributed to QOL. QIDS-SR (measuring depressive symptom severity), GAF, and SDS (measuring functioning/disability)
scores accounted for 48.1, 17.4, and 13.3 % (semi-partial correlation values) of the variance in Q-LES-Q, respectively.
community norm average is 78.3 %. Regression modeling suggested that depressive symptom severity, functioning/disability,
and age all significantly contributed to QOL. QIDS-SR (measuring depressive symptom severity), GAF, and SDS (measuring functioning/disability)
scores accounted for 48.1, 17.4, and 13.3 % (semi-partial correlation values) of the variance in Q-LES-Q, respectively.
Conclusions
Our results show that impairment of QOL increases in a monotonic fashion with depressive symptom severity; however, depression
symptom severity only accounted for 48.1 % of the QOL variance in our patient population. Furthermore, QOL is uniquely associated
with measures of Functioning. We believe these results demonstrate the need to utilize not only Symptom Severity scales, but
also Functioning and Quality of Life measures in MDD assessment, treatment, and research.
symptom severity only accounted for 48.1 % of the QOL variance in our patient population. Furthermore, QOL is uniquely associated
with measures of Functioning. We believe these results demonstrate the need to utilize not only Symptom Severity scales, but
also Functioning and Quality of Life measures in MDD assessment, treatment, and research.
- Content Type Journal Article
- Pages 1-12
- DOI 10.1007/s11136-012-0187-6
- Authors
- Waguih William IsHak, Cedars-Sinai Medical Center, 8730 Alden Drive, Thalians W-157, Los Angeles, CA 90048, USA
- Konstantin Balayan, Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Catherine Bresee, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Jared Matt Greenberg, Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Hala Fakhry, Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
- Scott Christensen, Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Mark Hyman Rapaport, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Journal Quality of Life Research
- Online ISSN 1573-2649
- Print ISSN 0962-9343