Deficits in psychological well-being and quality-of-life in minor depression: implications for DSM-V.
OBJECTIVE
To examine deficits in psychological well-being (PWB) and quality-of-life (QOL) in minor depressive disorder (Min D).


METHODS
Ninety-three subjects entering a treatment study for Min D were assessed using the QOL, Enjoyment and satisfaction questionnaire (Q-LES-Q), and the Psychological Well-Being Scale (PWBS). Scores were compared with major depressive disorder (MDD) and normative community samples.


RESULTS
Even though subjects had mild depressive severity, Q-LES-Q total scores for the Min D sample averaged nearly two standard deviations below the community norm. Almost 40% of Min D cases had Q-LES-Q scores in the lowest 1% of the population. Responses to most Q-LES-Q items were closer to subjects with MDD than to community norms. Mean standardized PWB scores were extremely low for subscales of Environmental Mastery and Self-Acceptance, low for Purpose in Life and Positive Relations with others, but within the normal range for Personal Growth and Autonomy. QOL and PWB measures had low correlations with depressive symptom severity, and scores were similar in the presence or absence of a prior history of MDD.


CONCLUSIONS
Mild depressive symptoms with Min D are associated with major deficits in QOL and PWB measures of environmental mastery and poor self-acceptance. Our findings suggest that diminished QOL and PWB may be intrinsic cognitive aspects of Min D with or without a history of MDD. It may be unnecessary in the DSM IV-TR to exclude the diagnosis of Min D if a subject has had a past episode of MDD. Minor depression exists along a continuum of depression. Deficits in psychological well-being and quality-of-life in minor depression are severe. No difference in these measures if minor depression existed with or without a history of major depression.
Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. anierenberg@partners.org
Andrew A
AA
Nierenberg
Mark Hyman
MH
Rapaport
Pamela J
PJ
Schettler
Robert H
RH
Howland
Juliana A
JA
Smith
Deidre
D
Edwards
Trisha
T
Schneider
David
D
Mischoulon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000209:etiology*; D003863:Depression / Q000150:complications* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D010549:Personal Satisfaction; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D055815:Young Adult