title: Health-related quality of life of primary care patients with depressive disorders.
abstract: Depressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear.
  
  
  
  In a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n=3707) at five years.
  
  
  
  Depression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory [BDI]) and HRQoL was very strong (r=-0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms.
  
  
  
  Among depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent.
authors.affiliation: Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Health Care and Social Services, P.O. Box 41, 04401 Järvenpää, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Riihimäki
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Sintonen
authors.affiliation: Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, P.O. Box 22, 00014 Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 900, 00029 HUS, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Vuorilehto
authors.affiliation: Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, P.O. Box 22, 00014 Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 900, 00029 HUS, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Jylhä
authors.affiliation: Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Saarni
authors.affiliation: Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, P.O. Box 22, 00014 Helsinki, Finland. Electronic address: erkki.isometsa@hus.fi.
authors.forename: E
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Comorbidity; Depression; Follow-up; Health-related quality of life; Primary care