February 2010  << Back  

Health-related quality of life in depression: A STAR*D report

Ella J. Daly, MB, MRCPsych*

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

*Ella J. Daly, MB, MRCPsych, is currently an employee of Johnson & Johnson PRD. At the time this work was completed, she was an assistant professor at the University of Texas Southwestern Medical School at Dallas, where she continues as an adjunct faculty member.

Madhukar H. Trivedi, MD

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Stephen R. Wisniewski, PhD

Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

Andrew A. Nierenberg, MD

Massachusetts General Hospital, Depression Clinical and Research Program, Boston, MA, USA

Bradley N. Gaynes, MD, MPH

Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA

Diane Warden, PhD, MBA

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

David W. Morris, PhD

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

James F. Luther, MA

Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

Amy Farabaugh, PhD

Massachusetts General Hospital, Depression Clinical and Research Program, Boston, MA, USA

Ian Cook, MD

UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA

A. John Rush, MD

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

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.

CONCLUSION: 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.

KEYWORDS: Health-related quality of life, major depressive disorder, domains of quality of life

ANNALS OF CLINICAL PSYCHIATRY 2010;22(1):43–55

CORRESPONDENCE: Madhukar H. Trivedi, MD, Professor of Psychiatry, Lydia Bryant Professorship in Psychiatric Research, Director, Mood Disorders Program, University of Texas, Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd. Dallas, TX 75390-9119 USA E-MAIL: madhukar.trivedi@utsouthwestern.edu
Annals of Clinical Psychiatry ©2010 American Academy of Clinical Psychiatrists

 
Read full article