Health-related quality-of-life measure enhances acute treatment response prediction in depressed inpatients

J Clin Psychiatry. 2001 Apr;62(4):261-8. doi: 10.4088/jcp.v62n0408.

Abstract

Background: Many nonbiological variables are reported to predict treatment response for major depression; however, there is little agreement about which variables are most predictive.

Method: Inpatient subjects (N = 59) diagnosed with current DSM-IV major depressive disorder completed weekly depressive symptom ratings with the Hamilton Rating Scale for Depression (HAM-D-17) and Beck Depression Inventory (BDI), and weekly health-related quality-of-life (HRQL) ratings with the Quality of Well-Being Scale (QWB). Acute responders were identified by a 50% decrease in HAM-D-17 score from baseline within 4 weeks of medication treatment. Predictor variables were initially chosen from a literature review and then tested for their association with acute treatment response.

Results: An initial predictive model including age at first depression, admission BDI score, and melancholia predicted acute treatment response with 69% accuracy and was designated as the benchmark model. Adding the admission QWB index score to the benchmark model did not improve the prediction rate; however, adding the admission QWB subscales for physical and social activity to the benchmark model significantly improved acute treatment response prediction to 86% accuracy (p = .001).

Conclusion: In addition to being designed for use in cost-effectiveness analyses, the QWB subscales appear to be useful HRQL variables for predicting acute inpatient depression treatment response.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Anticonvulsants
  • Antidepressive Agents / therapeutic use*
  • Bupropion / therapeutic use
  • Comorbidity
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Female
  • Health Status Indicators*
  • Hospitalization*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Statistical
  • Personality Inventory / statistics & numerical data
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Quality of Life*
  • Recurrence
  • Selective Serotonin Reuptake Inhibitors
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Serotonin Uptake Inhibitors
  • Bupropion