Health-related Quality of Life in Teens with Depression

描述(申请人提供)：抑郁症是青少年中最常见的精神障碍之一，具有许多负面后果，包括功能受损和未来出现问题的风险(例如，学习成绩不佳、人际关系受损、滥用药物和自杀)。年轻人的心理健康问题往往得不到承认，即使得到了承认，大多数人也得不到任何治疗。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计划提供资金。公共卫生政策制定者越来越多地使用与健康相关的生活质量(HRQL)指标来比较健康状况之间的疾病负担，而HRQL在抑郁症等疾病中尤其重要，在这些疾病中，死亡率和发病率等疾病负担的传统衡量标准不能充分反映疾病的影响。对不同健康状况的价值进行评级的措施，如基于效用的HRQL措施，在展示疾病负担、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方面特别有帮助。没有研究考察基于效用的HRQL测量在患有抑郁障碍的青少年中的使用情况。我们的最终目标是为青少年抑郁症研究和临床决策中的HRQL评估制定建议和指南。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的HRQL的理解。首先，我们将评估几种广泛使用的一般健康状况和基于效用的青少年HRQL测量的横断面效度和可靠性。其次，我们将检查HRQL量表在检测抑郁症诊断后12周内有临床意义的抑郁症症状变化方面的敏感性。 与公共健康相关：青少年抑郁症很常见，而且令人丧失能力。目前对青少年抑郁负担的衡量标准，如症状评分，并没有完全反映抑郁症对青少年生活的影响。更好地衡量抑郁症对青少年生活质量的影响将有助于评估新的治疗方法，并制定解决青少年抑郁症的公共卫生政策。

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.