Health-related quality-of-life measure enhances acute treatment response prediction in depressed inpatients.
BACKGROUND
Many nonbiological variables are reported to predict treatment response for major depression; however, there is little agreement about which variables are most predictive.


METHODS
Inpatient subjects (N = 59) diagnosed with current DSM-IV major depressive disorder completed weekly depressive symptom ratings with the Hamilton Rating Scale for Depression (HAM-D-17) and Beck Depression Inventory (BDI), and weekly health-related quality-of-life (HRQL) ratings with the Quality of Well-Being Scale (QWB). Acute responders were identified by a 50% decrease in HAM-D-17 score from baseline within 4 weeks of medication treatment. Predictor variables were initially chosen from a literature review and then tested for their association with acute treatment response.


RESULTS
An initial predictive model including age at first depression, admission BDI score, and melancholia predicted acute treatment response with 69% accuracy and was designated as the benchmark model. Adding the admission QWB index score to the benchmark model did not improve the prediction rate; however, adding the admission QWB subscales for physical and social activity to the benchmark model significantly improved acute treatment response prediction to 86% accuracy (p = .001).


CONCLUSIONS
In addition to being designed for use in cost-effectiveness analyses, the QWB subscales appear to be useful HRQL variables for predicting acute inpatient depression treatment response.
Pyne
J M
JM
Department of Psychiatry, Central Arkansas Veterans Healthcare System, Little Rock, USA. pynejeffreym@exchange.uams.edu
Bullock
D
D
Kaplan
R M
RM
Smith
T L
TL
Gillin
J C
JC
Golshan
S
S
Kelsoe
J R
JR
Williams
D K
DK
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000927:Anticonvulsants; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016642:Bupropion / Q000627:therapeutic use; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006305:Health Status Indicators; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000927:Anticonvulsants; D000928:Antidepressive Agents; D016642:Bupropion; D017367:Selective Serotonin Reuptake Inhibitors