Health-related quality of life in depression: a STAR*D report.
BACKGROUND
Although major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQOL), few studies have evaluated HRQOL dysfunction in multiple domains. This report examined the psychological, physical, and social domains in a large sample of outpatients who entered the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.


METHODS
The relationship of HRQOL and baseline sociodemographic and clinical features, including depressive severity, was evaluated. We assessed HRQOL with the 12-item Short Form Health Survey, the 5-item Work and Social Adjustment Scale, and the 16-item Quality of Life Enjoyment and Satisfaction Questionnaire.


RESULTS
Among 2307 participants, greater depressive symptom severity was associated with poorer HRQOL. After controlling for age and depression severity, lower HRQOL was related independently to being African American or Hispanic, less educated, unemployed, divorced or separated, having public medical insurance, and to having more general medical disorders. We found impairments across all 3 domains, with low correlations between the 3 measures of HRQOL chosen, suggesting that they evaluate different and nonoverlapping aspects of function.


CONCLUSIONS
Sociodemographically disadvantaged patients with greater general medical and depressive illness burden are at greatest risk for poorer quality of life. Distinct impairments are seen in the 3 domains of HRQOL.
Daly
Ella J
EJ
Department of Psychiatry, University of Texas Southwestern Medical School at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA.
Trivedi
Madhukar H
MH
Wisniewski
Stephen R
SR
Nierenberg
Andrew A
AA
Gaynes
Bradley N
BN
Warden
Diane
D
Morris
David W
DW
Luther
James F
JF
Farabaugh
Amy
A
Cook
Ian
I
Rush
A John
AJ
D000328:Adult; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D004522:Educational Status; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012919:Social Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires