Health-related Quality of Life in Teens with Depression

描述（由申请人提供）：抑郁症是青少年中最常见的精神障碍之一，具有许多负面影响，包括功能受损和未来问题的风险（例如，学习成绩差，人际关系受损，药物滥用和自杀）。青少年的心理健康问题往往得不到认识，即使认识到了，大多数人也没有得到任何治疗。有关青少年抑郁症负担的信息可以向卫生系统和公共卫生政策制定者展示青少年抑郁症作为一个健康问题的重要性——他们需要准确的信息来确定优先事项，并为鼓励青少年抑郁症治疗的项目提供资金。公共卫生政策制定者越来越多地使用与健康有关的生活质量（HRQL）指标来比较不同健康状况之间的疾病负担，而HRQL对于抑郁症等疾病尤其重要，因为传统的疾病负担指标，如死亡率和发病率，不能充分反映疾病的影响。评估不同健康状态价值的措施，如基于效用的HRQL措施，特别有助于显示疾病负担、分析新干预措施的成本效益，以及为临床和报销政策设定优先事项。没有研究检验了在青少年抑郁症患者中使用基于实用性的HRQL测量方法。我们的最终目标是为青少年抑郁症研究和临床决策中HRQL的评估提供建议和指南。本研究将通过完成以下具体目标来扩展对青少年抑郁症患者HRQL的理解。首先，我们将评估几个广泛使用的通用健康状况和基于实用性的青少年HRQL测量的横截面效度和信度。其次，我们将检验HRQL工具在抑郁症诊断后12周内检测临床有意义的抑郁症状变化的敏感性。

DESCRIPTION (provided by applicant): Depression is one of the most common mental disorders among adolescents and has many negative consequences including impaired functioning and risk for future problems, (e.g., poor school performance, impaired relationships, substance abuse, and suicide). Mental health problems in youth often go unrecognized, and, even when they are recognized, most do not receive any treatment. Information on the burden of youth depression could show health system and public health policymakers the importance of teen depression as a health issue--they need accurate information to set priorities and fund programs to encourage youth depression treatment. Public health policymakers are increasingly using measures of health-related quality of life (HRQL) to compare the burden of disease between health conditions and HRQL is especially important in illnesses such as depression, where traditional measures of disease burden, such as mortality and morbidity, do not adequately capture the impact of the illness. Measures that rate the value of different health states, such as utility-based HRQL measures, are particularly helpful in demonstrating the burden of disease, analyzing the cost-effectiveness of new interventions, and setting priorities for clinical and reimbursement policies. No studies that have examined the use of utility-based HRQL measures in youth with depressive disorder. Our ultimate aim is to develop recommendations and guidelines for the assessment of HRQL in youth depression studies and clinical policymaking. This study will extend the understanding of HRQL in teens with depression by completing the following specific aims. First, we will evaluate the cross-sectional validity and reliability of several widely-used generic health status and utility-based HRQL measures in teens. Second, we will examine the sensitivity of the HRQL instruments in detecting clinically meaningful depression symptom change over 12 weeks following depression diagnosis. PUBLIC HEALTH RELEVANCE: Depression in teens is common and disabling. Currently available measures of the burden of depression in teens, such as symptom ratings, do not capture the full impact of depression on teens' lives. Improved measurement of the impact of depression on teen's quality of life would aid in evaluating new treatments and in setting public health policies to address teen depression.