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Impact of severity and type of depression on quality of life in cases identified in the community

Published online by Cambridge University Press:  11 February 2010

R. Nuevo ,
C. Leighton ,
G. Dunn ,
C. Dowrick ,
V. Lehtinen ,
O. S. Dalgard ,
P. Casey ,
J. L. Vázquez-Barquero  and
J. L. Ayuso-Mateos
R. Nuevo
Affiliation:
Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
C. Leighton
Affiliation:
Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
G. Dunn
Affiliation:
Biostatistics, School of Community-Based Medicine, University of Manchester, UK
C. Dowrick
Affiliation:
Division of Primary Care, University of Liverpool, UK
V. Lehtinen
Affiliation:
National Research and Development Centre for Welfare and Health, Turku, Finland
O. S. Dalgard
Affiliation:
National Institute of Public Health, Oslo, Norway
P. Casey
Affiliation:
Department of Psychiatry, University College Dublin, Mater Misericordiae Hospital, Dublin, Ireland
J. L. Vázquez-Barquero
Affiliation:
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain Department of Psychiatry, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, Santander, Spain
J. L. Ayuso-Mateos*
Affiliation:
Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
*
*Address for correspondence: Dr J. L. Ayuso-Mateos, Hospital Universitario de La Princesa, Servicio de Psiquiatría, C/ Diego de León 62, 28006 Madrid, Spain. (Email: joseluis.ayuso@uam.es)
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Abstract

Background

The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level.

Method

A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36.

Results

Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent).

Conclusions

These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity.

Keywords

Depressive episodedisabilityquality of lifeseveritySF-36
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 12 , December 2010 , pp. 2069 - 2077
Copyright
Copyright © Cambridge University Press 2010

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