title: Quality of life in major depressive disorder before/after multiple steps of treatment and one-year follow-up.
abstract: OBJECTIVE
  This study examines the impact of major depressive disorder (MDD) and its treatment on quality of life (QOL).
  
  
  METHODS
  From the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, we analyzed complete data of 2280 adult MDD out-patients at entry/exit of each level of antidepressant treatments and after 12 months of entry to follow-up. QOL was measured using the QOL Enjoyment and Satisfaction Questionnaire (Q-LES-Q). The proportions of patients scoring 'within-normal' QOL (within 10% of Q-LES-Q community norms) and those with 'severely impaired' QOL (>2 SD below Q-LES-Q community norms) were analyzed.
  
  
  RESULTS
  Before treatment, no more than 3% of MDD patients experienced 'within-normal' QOL. Following treatment, statistically significant improvements were detected; however, the proportion of patients achieving 'within-normal' QOL did not exceed 30%, with >50% of patients experiencing 'severely impaired' QOL. Although remitted patients had greater improvements compared with non-remitters, 32-60% continued to experience reduced QOL. 12-month follow-up data revealed that the proportion of patients experiencing 'within-normal' QOL show a statistically significant decrease in non-remitters.
  
  
  CONCLUSIONS
  Symptom-focused treatments of MDD may leave a misleading impression that patients have recovered when, in fact, they may be experiencing ongoing QOL deficits. These findings point to the need for investigating specific interventions to ameliorate QOL in MDD.
authors: Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA.
authors: W W
authors: WW
authors: IsHak
authors: J
authors: J
authors: Mirocha
authors: D
authors: D
authors: James
authors: G
authors: G
authors: Tobia
authors: J
authors: J
authors: Vilhauer
authors: H
authors: H
authors: Fakhry
authors: S
authors: S
authors: Pi
authors: E
authors: E
authors: Hanson
authors: R
authors: R
authors: Nashawati
authors: E D
authors: ED
authors: Peselow
authors: R M
authors: RM
authors: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: antidepressants; functional outcomes; major depression; patient-reported outcomes; quality of life