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Health-related quality of life of primary care patients with depressive disorders

Published online by Cambridge University Press:  23 March 2020

K. Riihimäki ,
H. Sintonen ,
M. Vuorilehto ,
P. Jylhä ,
S. Saarni  and
E. Isometsä
K. Riihimäki
Affiliation:
Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland Department of Psychiatry, Health Care and Social Services, P.O. Box 41Järvenpää04401, Finland
H. Sintonen
Affiliation:
Department of Public Health, University of Helsinki, P.O. Box 20Helsinki00014, Finland
M. Vuorilehto
Affiliation:
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 22Helsinki00014, Finland Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 900HUS00029, Finland
P. Jylhä
Affiliation:
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 22Helsinki00014, Finland Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 900HUS00029, Finland
S. Saarni
Affiliation:
Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland University of Turku and Turku University Hospital, Turku, Finland
E. Isometsä*
Affiliation:
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 22Helsinki00014, Finland
*
* Corresponding author. Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki University Hospital, P.O. Box 22, 00014 Helsinki, Finland. Tel.: +358 9 471 63728; fax: +358 9 471 63735. E-mail address:erkki.isometsa@hus.fi (E. Isometsä).
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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.

Keywords

DepressionHealth-related quality of lifeComorbidityFollow-upPrimary care
Type
Original article
Information
European Psychiatry , Volume 37 , September 2016 , pp. 28 - 34
Copyright
Copyright © European Psychiatric Association 2016

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