Depression severity and concentration difficulties are independently associated with HRQOL in patients with unipolar dep
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Depression severity and concentration difficulties are independently associated with HRQOL in patients with unipolar depressive disorders A. Fattori1
•
L. Neri2 • A. Bellomo3 • M. Vaggi4 • C. Mencacci5 • the ILDE Study Group
Accepted: 9 May 2017 Ó Springer International Publishing Switzerland 2017
Abstract Purpose Cognitive impairment is a core feature of major depressive disorder (MDD), and dysfunctions in this area strongly contribute to MDD-associated disability. Whether cognitive impairment has an independent clinical course and a unique impact on HRQOL is still debated. We sought to characterize the relationship between depression severity and HRQOL, evaluating the burden of concentration difficulties on HRQOL. Methods Six hundred ninety-two patients with unipolar depressive disorders recruited in 19 Italian centers answered a self-administered survey (SF-12 questionnaire, socio-demographic information). A psychiatrist completed a standardized data collection form encompassing a depression severity scale (MADRS) and clinical information. Results There was a strong graded association between the severity of depressive symptoms and both the physical (x2 = 0.13; p \ 0.01) and mental (x2 = 0.34; p \ 0.01) Centers participating in the ILDE Study Group are listed in Appendix.
Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1595-4) contains supplementary material, which is available to authorized users. & A. Fattori [email protected] 1
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
2
Outcomes Research Consulting, Milan, Italy
3
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
4
Department of Mental Health, ASL3, Genoa, Italy
5
Depression Unit, Neuroscience Department, Fatebenefratelli Hospital, Milan, Italy
SF-12 domains. Additionally, we observed a strong association between concentration difficulties and all HRQOL outcomes independent of other symptoms of depression and robust to adjustment for possible confounders. Conclusions Our data corroborate previous findings suggesting that cognitive impairment is a feature of unipolar depressive disorders partially independent of the severity of other symptoms, and may represent a specific target of therapy with a strong impact on patients’ functioning and quality of life. Keywords Unipolar depressive disorder HRQoL Cognitive impairment Depression severity SF-12 MADRS
Introduction Depression is a primary determinant of years lost due to disability accounting for 24.5% of all disability-adjusted life years (DALYs) due to mental, neurological, and substance use disorders [1, 2]. Prevalence of lifetime depression ranges from 7.6 to 16.6% across countries [3, 4] and the economic burden has been estimated in 210 billion dollars per year in the USA only [5]. There is evidence that major depressive disorder (MDD) has a detrimental impact on functional impairment and health-related quality of life (HRQOL) compared to the general
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