Kathleen S Bingham1, Ellen M Whyte2, Benoit H Mulsant3, Anthony J Rothschild4, Matthew V Rudorfer5, Patricia Marino6, Samprit Banerjee7, Meryl A Butters2, George S Alexopoulos8, Barnett S Meyers8, Alastair J Flint9. 1. University of Toronto, Department of Psychiatry, Toronto, ON, Canada. Electronic address: kathleen.bingham@uhn.ca. 2. University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, United States. 3. University of Toronto, Department of Psychiatry, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada. 4. University of Massachusetts Medical School, Department of Psychiatry, Worcester, MA, United States. 5. National Institute of Mental Health, Rockville, MD, United States. 6. Weill Cornell Medical College, Department of Psychiatry, New York, NY, United States. 7. Weill Cornell Medical College, Department of Biostatistics and Epidemiology, New York, NY, United States. 8. Weill Cornell Medicine, New York-Presbyterian/Westchester Division, White Plains, NY, United States. 9. University of Toronto, Department of Psychiatry, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada.
Abstract
BACKGROUND: Some patients with major depression continue to demonstrate deficits in health-related quality of life (HRQL) following remission. No data exist, however, regarding HRQL in remitted psychotic depression. In this study, we aimed to characterize HRQL in patients with psychotic depression receiving controlled pharmacotherapy. METHODS: This is a secondary analysis of a randomized controlled trial studying continuation pharmacotherapy of psychotic depression. We compared participants' HRQL (measured using the SF-36) between baseline and remission and to population norms. We also compared SF-36 scores stratified by age and gender and examined the correlation between SF-36 scores and medical burden, depression score and neuropsychological performance in remission. RESULTS:SF-36 scores were significantly lower than population norms at baseline, but improved following remission to the level of population norms. Neither SF-36 scores nor magnitude of SF-36 improvement differed substantially between genders or between younger and older participants. In remission, depression scores were correlated with most SF-36 scales and medical burden was correlated with SF-36 scales measuring physical symptoms. Neuropsychological measures were generally not correlated with SF-36 scores. LIMITATIONS: This study was a secondary analysis not powered specifically to measure HRQL as an outcome variable and the SF-36 was the only HRQL measure used. CONCLUSIONS: Participants with remitted psychotic depression demonstrated levels of HRQL comparable to population norms, despite marked impairment in HRQL when acutely ill. This finding suggests that, when treated in a rigorous manner, many patients with this severe illness improve significantly from a clinical and HRQL perspective.
RCT Entities:
BACKGROUND: Some patients with major depression continue to demonstrate deficits in health-related quality of life (HRQL) following remission. No data exist, however, regarding HRQL in remitted psychotic depression. In this study, we aimed to characterize HRQL in patients with psychotic depression receiving controlled pharmacotherapy. METHODS: This is a secondary analysis of a randomized controlled trial studying continuation pharmacotherapy of psychotic depression. We compared participants' HRQL (measured using the SF-36) between baseline and remission and to population norms. We also compared SF-36 scores stratified by age and gender and examined the correlation between SF-36 scores and medical burden, depression score and neuropsychological performance in remission. RESULTS: SF-36 scores were significantly lower than population norms at baseline, but improved following remission to the level of population norms. Neither SF-36 scores nor magnitude of SF-36 improvement differed substantially between genders or between younger and older participants. In remission, depression scores were correlated with most SF-36 scales and medical burden was correlated with SF-36 scales measuring physical symptoms. Neuropsychological measures were generally not correlated with SF-36 scores. LIMITATIONS: This study was a secondary analysis not powered specifically to measure HRQL as an outcome variable and the SF-36 was the only HRQL measure used. CONCLUSIONS:Participants with remitted psychotic depression demonstrated levels of HRQL comparable to population norms, despite marked impairment in HRQL when acutely ill. This finding suggests that, when treated in a rigorous manner, many patients with this severe illness improve significantly from a clinical and HRQL perspective.
Authors: Ralf Pukrop; Volker Schlaak; Anne Maria Möller-Leimkühler; Margot Albus; Adelheid Czernik; Joachim Klosterkötter; Hans Jürgen Möller Journal: Psychiatry Res Date: 2003-07-15 Impact factor: 3.222
Authors: Tamilyn Bakas; Susan M McLennon; Janet S Carpenter; Janice M Buelow; Julie L Otte; Kathleen M Hanna; Marsha L Ellett; Kimberly A Hadler; Janet L Welch Journal: Health Qual Life Outcomes Date: 2012-11-16 Impact factor: 3.186
Authors: Alastair J Flint; Barnett S Meyers; Anthony J Rothschild; Ellen M Whyte; Benoit H Mulsant; Matthew V Rudorfer; Patricia Marino Journal: BMC Psychiatry Date: 2013-01-25 Impact factor: 3.630