Does the clinical course of depression determine improvement in symptoms and quality of life?

Tally Moses, Andrew F Leuchter, Ian Cook, Michelle Abrams

Journal: The Journal of nervous and mental disease 2006;194(4):241-8

PMID: 16614544

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Abstract

Clinical course factors characterizing individuals' history with depression may be helpful in predicting treatment-related change in quality of life (QOL). Such factors have been studied in relation to symptomatic change with mixed results. This 9-week single-blind treatment trial using reboxetine (1 week placebo lead-in) evaluated the impact of age of onset, history of antidepressant treatment, duration of index episode, number of past episodes, and the presence of precipitating stress on depressed individuals' treatment response. We found that QOL did not normalize along with clinical remission in all areas. Using multivariate analysis, we found that age of onset, history with antidepressants, and the presence of identifiable precipitating stress were all significant predictors of QOL change (controlling for symptomatic change); some factors also predicted symptomatic improvement. Our results support the trend of distinguishing between treatment-related change in QOL and symptomatic change and suggest clinical course factors as promising predictors of QOL.

Address: School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.

DOI: 10.1097/01.nmd.0000207358.15230.80

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MeSH Terms: Adult, Age of Onset, Antidepressive Agents, Depressive Disorder, Major, Female, Health Status, Humans, Life Change Events, Male, Morpholines, Multivariate Analysis, Probability, Psychiatric Status Rating Scales, Quality of Life, Reboxetine, Single-Blind Method, Surveys and Questionnaires, Time Factors, Treatment Outcome