Long-term follow-up on health-related quality of life in major depressive disorder: a 2-year European cohort study.
Long-term follow-up on health-related quality of life in major depressive disorder: a 2-year European cohort study.
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DOI：
10.2147/ndt.s159276
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发表时间：
2018
影响因子：
3.2
通讯作者：
Haro JM
中科院分区：
文献类型：
--
作者：
Saragoussi D;Christensen MC;Hammer-Helmich L;Rive B;Touya M;Haro JM
重度抑郁症（MDD）与健康相关生活质量（HRQoL）和日常功能的显著损害相关。这项队列研究调查了MDD患者HRQoL的长期发展及其与患者特征的相关性，包括抑郁症状严重程度和认知症状。重性抑郁障碍相关功能结局的前瞻性流行病学研究（PERFORM）研究是一项在法国、德国、西班牙、瑞典和英国的1,159例18-65岁MDD门诊患者中进行的纵向队列研究。患者开始抗抑郁药单药治疗或首次转换抗抑郁药。使用医学结局研究简表12项健康调查（SF-12）评估HRQoL，直至第12个月，使用EuroQol五维问卷评估HRQoL，直至第24个月（仅限英国）。抑郁症状严重程度通过患者报告的患者健康问卷进行评估，认知症状通过感知缺陷问卷进行评估，直至24个月。进行多变量分析，以确定与HRQoL相关的患者特征。与正常数据相比，基线时精神HRQoL严重受损（平均[SD] SF-12精神健康总评[MCS]，26.5 [9.2]）;平均（SD）身体健康总评（PCS）总分为45.2（12.1）。SF-12 MCS在12个月随访期间改善（第12个月时为38.7 [11.6]），而SF-12 PCS保持稳定（45.3 [11.1]）。在每个评估时间点，在经历更严重认知问题的患者中存在SF-12 MCS和PCS总分较低的明显模式。平均EuroQol五维问卷效用指数评分普遍下降（即，恶化），在长达24个月的所有时间点，认知和抑郁症状的严重程度增加。多变量分析表明抑郁症的严重程度和认知症状与HRQoL不良有显著相关性。这些发现强调了识别和管理MDD患者的残留症状（包括认知症状）以恢复长期心理社会功能的重要性。
Major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQoL) and everyday functioning. This cohort study investigated the long-term development of HRQoL in patients with MDD and its association with patient characteristics, including depressive symptom severity and cognitive symptoms. The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study was a longitudinal cohort study conducted in 1,159 outpatients aged 18–65 years with MDD in France, Germany, Spain, Sweden, and the UK. The patients were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. HRQoL was assessed using the Medical Outcomes Study Short-Form 12-item Health Survey (SF-12) up to month 12 and the EuroQol Five Dimensions questionnaire up to month 24 (UK only). Depressive symptom severity was assessed up to month 24 by the patient-reported Patient Health Questionnaire and cognitive symptoms by the Perceived Deficit Questionnaire. Multivariate analyses were performed to identify patient characteristics associated with HRQoL. Mental HRQoL was severely impaired at baseline versus normative data (mean [SD] SF-12 mental component summary [MCS], 26.5 [9.2]); mean (SD) physical component summary (PCS) total score was 45.2 (12.1). SF-12 MCS improved over 12 months of follow-up (38.7 [11.6] at month 12), while SF-12 PCS remained stable (45.3 [11.1]). At each assessment time point, there was a clear pattern of lower SF-12 MCS and PCS total score in patients experiencing greater cognitive problems. The mean EuroQol Five Dimensions questionnaire utility index score generally decreased (i.e., worsened) with increasing severity of cognitive and depressive symptoms at all time points up to 24 months. Multivariate analyses identified both depression severity and cognitive symptoms as strongly and significantly associated with poor HRQoL. These findings highlight the importance of recognizing and managing residual symptoms in patients with MDD, including the cognitive symptoms, to restore long-term psychosocial functioning.