K Riihimäki1, H Sintonen2, M Vuorilehto3, P Jylhä3, S Saarni4, E Isometsä5. 1. 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. 2. Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland. 3. 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. 4. Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; University of Turku and Turku University Hospital, Turku, Finland. 5. 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.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: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. METHODS: 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. RESULTS: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. CONCLUSIONS: 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: Mirkka J Hirvonen; Rafael Pasternack; Tiina Lipitsä; Armi Vihervaara; Rauno Harvima; Martta Ranta; Harri Sintonen; Laura Huilaja Journal: Skin Appendage Disord Date: 2021-12-27
Authors: Claudi Bockting; Amanda M Legemaat; Johanne G J van der Stappen; Gert J Geurtsen; Maria Semkovska; Huibert Burger; Isidoor O Bergfeld; Nicoline Lous; Damiaan A J P Denys; Marlies Brouwer Journal: BMJ Open Date: 2022-06-23 Impact factor: 3.006
Authors: Hanna Wersebe; Roselind Lieb; Andrea H Meyer; Marcel Miche; Thorsten Mikoteit; Christian Imboden; Jürgen Hoyer; Klaus Bader; Martin Hatzinger; Andrew T Gloster Journal: Int J Clin Health Psychol Date: 2018-08-06