Quality of life in major depressive disorder before/after multiple steps of treatment and one-year follow-up

ObjectiveThis study examines the impact of major depressive disorder (MDD) and its treatment on quality of life (QOL). MethodFrom the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, we analyzed complete data of 2280 adult MDD out-patients at entry/exit of each level of antidepressant treatments and after 12 months of entry to follow-up. QOL was measured using the QOL Enjoyment and Satisfaction Questionnaire (Q-LES-Q). The proportions of patients scoring within-normal' QOL (within 10% of Q-LES-Q community norms) and those with severely impaired' QOL (>2SD below Q-LES-Q community norms) were analyzed. ResultsBefore treatment, no more than 3% of MDD patients experienced within-normal' QOL. Following treatment, statistically significant improvements were detected; however, the proportion of patients achieving within-normal' QOL did not exceed 30%, with >50% of patients experiencing severely impaired' QOL. Although remitted patients had greater improvements compared with non-remitters, 32-60% continued to experience reduced QOL. 12-month follow-up data revealed that the proportion of patients experiencing within-normal' QOL show a statistically significant decrease in non-remitters. ConclusionSymptom-focused treatments of MDD may leave a misleading impression that patients have recovered when, in fact, they may be experiencing ongoing QOL deficits. These findings point to the need for investigating specific interventions to ameliorate QOL in MDD.