Factors associated with health-related quality of life among outpatients with major depressive disorder: a STAR*D report.
OBJECTIVE
Major depressive disorder (MDD) is often chronic and is often associated with significant morbidity and mortality. The importance of assessing disability and health-related quality of life (HRQOL) in patients with MDD has only recently been recognized. The aim of this study was to examine sociodemographic and clinical correlates of HRQOL in a large cohort of outpatients with MDD.


METHODS
Baseline assessments were completed for 1500 consecutive patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression trial, including sociodemographic characteristics and measures of depressive symptom severity, clinical features, and HRQOL. Multiple domains of HRQOL were assessed with the 12-item Short Form Health Survey, the Work and Social Adjustment Scale, and the Quality of Life Enjoyment and Satisfaction Questionnaire. The current analyses were conducted on HRQOL data available for 1397 of the 1500 subjects.


RESULTS
Greater symptom severity was associated with reduced HRQOL by all measures. Even after age and symptom severity were controlled for, a number of clinical features and sociodemographic characteristics were independently associated with HRQOL in multiple domains, including age at onset of MDD, ethnicity, marital status, employment status, education level, insurance status, and monthly household income.


CONCLUSIONS
Results strongly suggest the need to assess HRQOL in addition to symptoms in order to gauge the true severity of MDD. This study also highlights the necessity of measuring HRQOL in multiple domains. These results have implications for the assessment of remission and functional recovery in the treatment of MDD.
Trivedi
Madhukar H
MH
Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas 75390-9119, and the Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston, USA. madhukar.trivedi@utsouthwestern.edu
Rush
A John
AJ
Wisniewski
Stephen R
SR
Warden
Diane
D
McKinney
William
W
Downing
Michael
M
Berman
Susan R
SR
Farabaugh
Amy
A
Luther
James F
JF
Nierenberg
Andrew A
AA
Callan
Judith A
JA
Sackeim
Harold A
HA
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000553:Ambulatory Care; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D012917:Social Adjustment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D017367:Selective Serotonin Reuptake Inhibitors