Impact of escitalopram treatment on Quality of Life Enjoyment and Satisfaction Questionnaire scores in major depressive disorder and generalized anxiety disorder

Abstract

Administration of the same Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) in major depressive disorder (MDD) and in generalized anxiety disorder (GAD) before and after treatment allowed us to compare quality of life enjoyment and satisfaction in these two disorders and to compare outcome based on symptoms versus functioning. Q-LES-Q and symptom-specific Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Scale (HAMA) data from eight randomized, 8-week, double-blind, placebo-controlled clinical trials with escitalopram were used. MDD (n=1,140) or GAD (n=1,045) patients report a substantial degree of quality of life enjoyment and satisfaction impairment (baseline scores 64% and 76% of community norm, respectively). Treatment resulted in statistically and clinically significant improvement in quality of life enjoyment and satisfaction. The improvement was greater in patients treated with escitalopram than with placebo. In MDD, the majority of remitters (MADRS<or=12) reached 'normal' quality of life enjoyment and satisfaction levels, whereas in GAD, 67% of remitters (HAMA<or=7) reached 'normal' quality of life, enjoyment, and satisfaction. A strong correlation between the symptom-specific scales and the Q-LES-Q was observed. These analyses suggest that remission with scores of 6 on the MADRS and 5 on the HAMA correspond with a quality of life enjoyment and satisfaction found in community comparison patients (Q-LES-Q score of 58+/-10%). Treatment with escitalopram results in a significant improvement of quality of life enjoyment and satisfaction in patients with MDD or GAD. Both response and remission in patients with GAD and remission in patients with MDD are correlated with a 'normal' quality of life enjoyment and satisfaction.