title: Improvement in self-reported quality of life with cognitive therapy for recurrent major depressive disorder.
abstract: BACKGROUND
  Major depressive disorder (MDD) is common, often recurrent and/or chronic. Theoretically, assessing quality of life (QoL) in addition to the current practice of assessing depressive symptoms has the potential to offer a more comprehensive evaluation of the effects of treatment interventions and course of illness.
  
  
  METHODS
  Before and after acute-phase cognitive therapy (CT), 492 patients from Continuation Phase Cognitive Therapy Relapse Prevention trial (Jarrett et al., 2013; Jarrett and Thase, 2010) completed the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Inventory of Depressive Symptomatology Self-report (IDS-SR) and Beck Depression Inventory (BDI); clinicians completed Hamilton Rating Scale for Depression-17-items. Repeated measures analysis of variance evaluated the improvement in QoL before/after CT and measured the effect sizes. Change analyses to assess clinical significance (Hageman and Arrindell, 1999) were conducted.
  
  
  RESULTS
  At the end of acute-phase CT, a repeated measure analysis of variance produced a statistically significant increase in Q-LES-Q scores with effect sizes of 0.48-1.3%; 76.9-91.4% patients reported clinically significant improvement. Yet, only 11-38.2% QoL scores normalized. An analysis of covariance showed that change in depression severity (covariates=IDS-SR, BDI) completely accounted for the improvement in Q-LES-Q scores.
  
  
  CONCLUSIONS
  There were only two time points of observation; clinically significant change analyses lacked matched normal controls; and generalizability is constrained by sampling characteristics.
  
  
  CONCLUSIONS
  Quality of life improves significantly in patients with recurrent MDD after CT; however, this improvement is completely accounted for by change in depression severity. Normalization of QoL in all patients may require targeted, additional, and/or longer treatment.
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9149, USA. Electronic address: manishjha2201@yahoo.com.
authors.forename: Manish Kumar
authors.initials: MK
authors.lastname: Jha
authors.affiliation: Department of Clinical Sciences, The University of Texas Southwestern Medical Center, USA.
authors.forename: Abu
authors.initials: A
authors.lastname: Minhajuddin
authors.affiliation: The Perelman School of Medicine of the University of Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, USA; University of Pittsburgh Medical Center, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9149, USA. Electronic address: Robin.Jarrett@UTSouthwestern.edu.
authors.forename: Robin B
authors.initials: RB
authors.lastname: Jarrett
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012008:Recurrence; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Cognitive therapy; Major depressive disorder; Quality of life
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