Abstract
Purpose
Health-related quality of life (HRQOL) can be significantly impaired by the presence of chronic conditions such as cardiovascular
disease (CVD) and major depressive disorder (MDD). The aim of this paper was to (1) identify differences in HRQOL between
individuals with CVD, MDD, or both, compared to a healthy reference group, (2) establish whether the influence of co-morbid
MDD and CVD on HRQOL is additive or synergistic and (3) determine the way in which depression severity interacts with CVD
to influence overall HRQOL.
disease (CVD) and major depressive disorder (MDD). The aim of this paper was to (1) identify differences in HRQOL between
individuals with CVD, MDD, or both, compared to a healthy reference group, (2) establish whether the influence of co-morbid
MDD and CVD on HRQOL is additive or synergistic and (3) determine the way in which depression severity interacts with CVD
to influence overall HRQOL.
Methods
Population-based data from the 2007 Australian National Survey of Mental Health and Well-being (NSMHWB) (n = 8841) were used to compare HRQOL of individuals with MDD and CVD, MDD but not CVD, CVD but not MDD, with a healthy reference
group. HRQOL was measured using the Assessment of Quality of Life (AQOL). MDD was identified using the Composite International
Diagnostic Interview (CIDI 3.0).
group. HRQOL was measured using the Assessment of Quality of Life (AQOL). MDD was identified using the Composite International
Diagnostic Interview (CIDI 3.0).
Results
Of all four groups, individuals with co-morbid CVD and depression reported the greatest deficits in AQOL utility scores (Coef:
−0.32, 95% CI: −0.40, −0.23), after adjusting for covariates. Those with MDD only (Coef: −0.27, 95% CI: −0.30, −0.24) and
CVD only (Coef: −0.08, 95% CI: −0.11, −0.05) also reported reduced AQOL utility scores. Second, the influence of MDD and CVD
on HRQOL was shown to be additive, rather than synergistic. Third, a significant dose–response relationship was observed between
depression severity and HRQOL. However, CVD and depression severity appeared to act independently of each other in impacting
HRQOL.
−0.32, 95% CI: −0.40, −0.23), after adjusting for covariates. Those with MDD only (Coef: −0.27, 95% CI: −0.30, −0.24) and
CVD only (Coef: −0.08, 95% CI: −0.11, −0.05) also reported reduced AQOL utility scores. Second, the influence of MDD and CVD
on HRQOL was shown to be additive, rather than synergistic. Third, a significant dose–response relationship was observed between
depression severity and HRQOL. However, CVD and depression severity appeared to act independently of each other in impacting
HRQOL.
- Content Type Journal Article
- Pages 1-8
- DOI 10.1007/s11136-012-0128-4
- Authors
- Adrienne O’Neil, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, Australia
- Christopher E. Stevenson, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, Australia
- Emily D. Williams, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, Australia
- Duncan Mortimer, Centre for Health Economics, Faculty of Business and Economics, Monash University, Wellington Road, Clayton, VIC, Australia
- Brian Oldenburg, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, Australia
- Kristy Sanderson, Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart, TAS, Australia
- Journal Quality of Life Research
- Online ISSN 1573-2649
- Print ISSN 0962-9343