Life In Depressed Patients Research Articles

Comparison of the Effects of Repetitive Transcranial Magnetic Stimulation and Aerobic Exercise as an Adjunct Therapy in Depressed Patients on Activity of Daily Living and Quality of Life

Background: Depression is one of the most common causes of disabilities and poor quality of life worldwide. One-fifth of patients fail to respond to antidepressant therapy. Hence, adjunct therapy is urgently needed. Aim: This study aims to compare the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and aerobic exercise as adjunct therapy on activity of daily living and quality of life in depressed patients. Material and Methods: A randomized-controlled experiment was conducted between May 2019 and January 2020. Twenty-seven depressed patients were divided into three groups for two weeks: antidepressant-only, antidepressant-and-aerobic exercise, and antidepressant-and-rTMS. The Barthel Index and SF-36 were used to assess the activity of daily living and quality of life. Results: After the intervention, there were no appreciable changes in the Barthel Index scores in any of the three groups (p>0.05). Following therapy, SF-36 results for physical function, bodily discomfort, public health, vitality, social function, emotional role functioning, and mental health all showed substantial improvements across groups (p 0.05). Patients in the antidepressant and rTMS groups improved more than those in the other two groups in the areas of overall health (15.71±6.075, p=0.009), emotional role functioning (20.29±11.940, p=0.049), and mental health (14.29±6.075, p=0.041). However, the Barthel Index score changes did not differ between groups (p=0.664). Conclusion: Better quality of life improvement in the rTMS group compared to the other two groups supports the use of rTMS as an additional therapy. It aims to enhance quality of life in patients with moderate and severe first-episode depression.

The Role of Emotion Regulation Difficulties in the Relation Between Suicide Risk and the Quality of Life in Depressive Patients

This research is based on existing research in the literature referring to the relationship amongst emotion regulation difficulties, quality of life, depression and suicide risk in depressed patient. The main goal of this research is to identify the role of emotion regulation difficulties in the relationship between suicide risk and quality of life in depressed patients. Data were collected using a general demographic questionnaire plus specific psychometric tests: Difficulties in emotional regulation scale (DERS-SF), Quality of life inventory (Qoli), Columbia suicide severity rating scale (C-SSRS), and Depression Anxiety Stress Scales (DASS21-R). The study included 109 participants, aged 18 – 60 years ((M= 36, SD=12.75), 37 (33.9%) men and 72 (66.1%) women, 49 from a rural background (45%) and 60 from urban background (55%), 43 in the clinical group - patients with depression (39.4%) and 66 in the non-clinical group - controls (60.6%). The results reinforce all the hypotheses of the research and point out the role of emotion regulation difficulties in the relation between suicide risk and the quality of life in depressive patients. Thus, the level of depression, severity of suicide risk and emotion regulation difficulties negatively influence the quality of life. The research findings point out that emotion regulation difficulties should be taken into account when designing psychotherapy programs and protocols aiming at increasing the quality of life and reducing the risk of suicide in depressive patients.

Physical activity for the treatment and prevention of depression: a rapid review of meta-analyses

Aim: We conducted an umbrella review of 55 meta-analyses to summarize current evidence on the effects of exercise on depression. Results: Aerobic, resistance or combined exercise for several weeks as well as mind-body exercise has shown to yield significant moderate effects on depression severity in adult patients, including the elderly. The effect diminishes when only high-quality studies are analyzed but reaches similar magnitude of other efficacious treatments. Additionally, exercise showed positive effects on sleep, cardiorespiratory fitness and quality of life in depressed patients. In children and adolescents and during the peripartum period, exercise interventions have been found have small-to-moderate effects, but studies varied in methodology and methodical quality could be improved (heterogeneous samples, blinding). Regular physical activity has been shown to have a protective effect on incident depression in adults, reducing odds by 17 to 21%. In children and adolescents, the effect tends to be smaller. Across 15 meta-analyses in samples with physical diseases, exercise-regimes have been shown to have positive effects on depressive symptoms in chronic conditions (such as pain, obesity or cardiovascular disease), cancer survivors, and in post-stroke, neurological and cardiovascular conditions, as well as in diabetes, chronic kidney disease, arthritis and HIV. Discussion: Exercise and physical activity have a wide range of benefits for depression and depressive symptoms in at-risk populations. Further research is needed to find optimal dose and duration of exercise-treatment and ways to sustainably increase physical activity in psychiatric populations and patients with chronic diseases. Key Words: Exercise, Aerobic, Resistance, Depressive Symptoms, At-Risk Population

Does depression treatment improve the survival of depressed patients with cancer? A long-term follow-up of participants in the SMaRT Oncology-2 and 3 trials

Comorbid major depression has been associated with worse survival in patients with cancer. However, we do not know if treating depression improves survival. In the SMaRT Oncology-2 (good prognosis cancers) and SMaRT Oncology-3 (lung cancer, a poor prognosis cancer) trials, we found that a depression treatment programme, Depression Care for People with Cancer (DCPC), was effective in reducing comorbid major depression. In this analysis, we aimed to identify whether DCPC also had an effect on survival. The trials were conducted in three cancer centres and their associated clinics in Scotland, UK. In SMaRT Oncology-2, outpatients with good prognosis cancers and major depression were randomly assigned in a 1:1 ratio to DCPC or usual care, with stratification (by trial centre) and minimisation (by age, primary cancer, and sex) with allocation concealment. In SMaRT Oncology-3, outpatients with lung cancer and major depression were randomly assigned (1:1 ratio) to DCPC or usual care with stratification (by trial centre) and minimisation (by age, sex, and cancer type) with allocation concealment. For this analysis, we obtained long-term data on deaths (all causes) in the SMaRT Oncology-2 and 3 trial participants, censored at July 31, 2015, and analysed survival as a trial outcome. We estimated unadjusted hazard ratios (HRs) for each trial using Cox regression, and pooled the log HRs in a fixed-effects meta-analysis. We recruited 642 participants; between May 12, 2008, and May 13, 2011, 500 participants were recruited to the SMaRT Oncology-2 trial and between Jan 5, 2009, and Sept 9, 2011, 142 participants were recruited to the SMaRT Oncology-3 trial. We followed up SMaRT Oncology-2 and SMaRT Oncology-3 participants for a median of 5 years and 1 year, respectively. 135 (27%) of 500 SMaRT Oncology-2 participants and 114 (80%) of 142 SMaRT Oncology-3 participants died within this period. We found no significant effect of DCPC on survival in the total follow-up period for either SMaRT Oncology 2 (HR 1·02, 95% CI 0·72-1·42, p=0·93) or SMaRT Oncology-3 (HR 0·82, 95% CI 0·56-1·18, p=0·28; pooled HR 0·92, 95% CI 0·72-1·18, p=0·51). DCPC is highly effective in improving depression and quality of life in depressed patients with cancer, but there was no evidence for a significant effect on survival. Despite the absence of an effect on length of life, the management of depression remains important for its beneficial effect on quality of life. NIHR CLAHRC Oxford, Cancer Research UK, and the Chief Scientist Office of the Scottish Government.

A Case Control Study of Subjective Quality of Life in Outpatients with Depression

Background: Depression is one of the leading causes of disability including impairment in the subjective Quality of Life (QOL) of the patient. Unfortunately, only a fraction receives the correct diagnosis and treatment in general practice. This study aims to determine the subjective Quality of Life of depressed patients. Method: A representative sample of adults, 18 years and above (100 each for cases and controls), were assessed for QOL using the World Health Organization Quality of Life instrument (WHOQOL-BREF). Respondents were also evaluated for socio-demographic factors. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview. Severity of depression was measured using Hamilton’s Rating Scale for Depression and global functioning was assessed with the Global Assessment of Functioning scale. Results: Majority of the participants were females (62.0%) and young with a mean age of 39.11 ± 12.40 years. Overall subjective QOL (P P P P P P < 0.001) in depressed patients compared to healthy control. Conclusion: The finding of the study showed that depression is a serious illness that affects the patient’s perception of the quality of his/her life. It is therefore very necessary to innovate better treatment modalities to reduce its burden.

Chemotherapeutic Response and Prognosis among Lung Cancer Patients with and without Depression.

Purpose: The current study examined quality of life, progression of disease, and survival rate during chemotherapy in newly diagnosed non-small cell lung cancer (NSCLC) patients with depression (n=48) and without depression (n=78). Further, the study explored the hypothesis that the survival benefit resulted from the chemotherapy of docetaxel and cisplatin (the DC regimen).Patients and Methods: In total, 126 patients with newly diagnosed NSCLC participated in a cross-sectional study of DC chemotherapy integrated with standard oncology care in depression and non-depression groups. The health-related quality of life (HR-QOL) was assessed using the quality of life questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC). Depression was self-rated using the Zung Self-Rating Depression Scale (Z-SDS). Both HR-QOL and Z-SDS were completed before the first and after the last cycle of chemotherapy. Association between depression and quality of life, treatment responses, adverse effects and survival rate was considered positive at the significance level of p<0.05. Pearson and Spearman correlation coefficient, t-test and other statistical analysis were performed using the SPSS software version 13.0 for Windows.Results: In total, 126 lung cancer patients were evaluated, 38% had a diagnosis of depression. The presence of depression was associated with reduced quality of life, increased progression of disease, nausea and fatigue and reduced survival rate by nearly 90 days on follow-up. Therefore, depression significantly predicted worse survival (P=0.009).In addition, the chemotherapy DC regimen did not appear to improve the quality of life in depressed patients (SDS 94.96±18.14 before chemotherapy vs. SDS 100.04±16.61 after therapy, P=0.155). In a secondary analysis, there was a positive relationship between depression and nausea and fatigue but there was no significant difference in hematologic toxicities between the depression and non-depression groups.Conclusion: Depression was associated with worse survival in patients with newly diagnosed NSCLC. Also, the chemotherapy DC regimen did not improve quality of life in depressed patients and the data do not support the hypothesis that treatment responses of NSCLC patients with depression mediated the observed survival benefit from the DC regimen. There were more cases of progressed disease in the depressed group. Findings suggest that NSCLC patients with depression are at increased risk for decline in HR-QOL and survival rate during chemotherapy than patients without depression.

Quality of Life in Depressed Patients in UK Primary Care: The FINDER Study.

ObjectivesTo investigate the impact of depression and its treatment on health-related quality of life (HRQoL) in a naturalistic, primary care setting in the UK.MethodsThe Factors Influencing Depression Endpoints Research (FINDER) study was a European, 6-month, prospective, observational study designed to estimate HRQoL in patients with a clinical diagnosis of depression. This paper examines primary care patients recruited in the UK. HRQoL was measured at baseline and at 3 and 6 months after starting antidepressant therapy using the Short Form 36 Health Status Survey and the European Quality of Life-5 Dimensions (EQ-5D). Regression analysis was used to identify baseline and treatment variables independently and significantly associated with HRQoL. Further analyses included the effect of caseness for depression on HRQoL, the effect of moderate/severe pain at baseline on HRQoL, changes in overall pain, pain interference scores, and the use of different antidepressants by pain cohort.ResultsA total of 608 patients was recruited from 58 centres and mean HRQoL was significantly below reported population norms at baseline. Most improvement in HRQoL was seen at 3 months for EQ-5D, with small additional improvement at 6 months. Worse HRQoL outcomes at 6 months were associated with higher somatic symptoms score, duration of depression at baseline, and switching within antidepressant classes. Patients meeting the criteria for caseness for depression, or with significant pain at baseline showed less improvement in HRQoL scores at 6 months.ConclusionPatients presenting with depression in primary care show reduced HRQoL compared to population norms. HRQoL improves during antidepressant treatment particularly within the first 3 months. Nonpainful somatic symptoms, socioeconomic factors, depression variables and switching within antidepressant class predict poor HRQoL outcome. Pain is a common symptom in depressed patients and remains after 6 months’ treatment. Pain and somatic symptoms should be assessed in all patients with depression in primary care.

Contribution of attachment insecurity to health-related quality of life in depressed patients

To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood. Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States). ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer (F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R(2) = 0.79; Adjusted R(2) = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders. The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.

P01-297 Health-related quality of life in depressed patients: 6-month results from the French cohort of finder study

Objectives:to describe the impact of pain on quality of life (QoL) in patients with depressionMethods:FINDER was a 6-month, european observational study to assess outcomes of QoL (SF36, EQ-5D), depression and anxiety (HADS), somatic (SSI) and pain (VAS) in a clinically diagnosed population initiating antidepressants.Results:606 patients enrolled in France by 57 psychiatrists and 46 general practitioners were 45.6±13.0 years old, 69% female and 39% have had a previous episode in the last 2 years. According to the patient rated HADS score greater than 11, 75% of patients were classified as cases for depression and 84% as cases for anxiety. 51% of patients rated their overall pain severity (based on VAS cut-off of 30) as moderate/severe, with 65% of them reporting no medical explanation for their pain.During the 6-month follow-up, French patients improved on SF36 physical score (46.8±10.4 to 50.2±8.3) and mental score (20.2±8.6 to 40.5±12.3), EQ-5D Health State Index (0.38±0.28 to 0.75±0.27) and EQ-5D VAS (39.9±20.0 to 71.4±20.3). Patients with moderate/severe pain at baseline and patients defined as cases for depression or anxiety at baseline had poorer QoL scores on SF36 physical score, EQ-5D Health State Index, EQ-5D VAS and HADS both at baseline and over the 6 months of since treatment started.Conclusions:Over half of French patients of this study experienced pain associated with depression. We observed that patients experiencing a moderate/severe pain at baseline had worse outcomes on QoL and depression response than those with mild or not pain at baseline.

Predictors of the longitudinal course of depression and quality of life in depressed patients

Predictors of the longitudinal course of depression and quality of life in depressed patients

Determinants of subjective quality of life in depressed patients: The role of self-esteem, response styles, and social support

Background We aimed to assess the subjective quality of life (QOL) in depressed patients after discharge from inpatient treatment and to investigate the net impact of self-related constructs (self-esteem, response styles to depressed mood) and of social support on specific subjective QOL domains. Method Four weeks after discharge from inpatient treatment, 89 unipolar depressed patients were assessed with a comprehensive battery of psychopathology and psychosocial measures. Subjective QOL was assessed using the World Health Organization Quality of Life Scale (WHOQOL-BREF). Analyses included hierarchical regressions. Results Non-remitted patients reported poorer subjective QOL than fully and partially remitted patients regarding physical and psychological health, and overall QOL. After adjusting for demographic and clinical history variables, interviewer-rated severity of depression accounted for 4% to 36% of the variance in individual QOL domain scores. Self-esteem, rumination, distraction and the existence of a partnership added further increments to the explained variance of the psychological QOL domain. Rumination, partnership, and network size of family members providing psychological crisis support also predicted subjective QOL on the social relations domain. Conclusion Our results suggest that self-esteem, response styles to depressed mood, and social support characteristics contribute substantially to the psychological and social domains of subjective QOL in depressed patients. These associations are not attributable to concurrent symptom severity. Therapy with depressed patients should not only focus on symptom reduction but should help the patients to establish and maintain supportive relationships and to enhance self-appreciation and skills to cope with negative mood in order to improve psychological well-being and health-related quality of life.

P.2.022 The effects of long term paroxetine therapy on the ability to work and the quality of life in depressed patients

P.2.022 The effects of long term paroxetine therapy on the ability to work and the quality of life in depressed patients

Quality of Life in Depression Scale (QLDS): Adaptation and evaluation of the psychometric properties of the Norwegian version

Despite the prevalence of depression, few studies on the quality of life of depressed patients have been conducted. The Quality of Life in Depression Scale (QLDS) is the first depression-specific measure. Since its publication in 1992, the measure has been adapted and re-validated for use in several countries. This paper describes the adaptation and psychometric evaluation of the Norwegian version of the QLDS. The QLDS was translated into Norwegian by means of bilingual and lay translation panels. Face and content validity was assessed, and a validation study was conducted with 72 depressed patients in order to establish the new adaptation's internal consistency, reproducibility, construct validity and responsiveness. No major problems were experienced during the translation of the QLDS into Norwegian and patient interviews indicated that the questionnaire was both acceptable to and relevant for depressed patients. The validation/adaptation of the QLDS into Norwegian had been successful. High test–retest correlations indicated excellent reproducibility with no evidence of excessive random measurement error. The internal consistency of the measure was confirmed, with items adequately inter-related. Evidence of construct validity and responsiveness is also encouraging. The Norwegian QLDS is a reliable and valid measure of quality of life.

Use of the quality of well-being self-administered version (QWB-SA) in assessing health-related quality of life in depressed patients

Background: This study evaluated the cross-sectional and longitudinal relationship between depression severity and the Quality of Well-Being scale self-administered version (QWB-SA) in subjects diagnosed with current major depression. Methods: The research design was prospective and observational. Data were collected on a convenience sample of 58 subjects. Additional measures included the Quality of Well-Being scale interviewer-version (interviewer-QWB), Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory, and each were collected at baseline, 4 weeks, and 4 months postmedication treatment. Results: Cross-sectional and longitudinal QWB-SA scores were significantly correlated with depression severity and the interviewer-QWB. Treatment response, defined as 50% improvement in HRSD-17, was associated with 0.10 and 0.16 unit changes in the QWB-SA at 4 weeks and 4 months, respectively. The QWB-SA was significantly and negatively correlated with cross-sectional and longitudinal depression severity. Limitations: The study design was observational and used a convenience sample of subjects. Conclusions: The QWB-SA is less expensive to administer than the interviewer-QWB and is a useful alternative for determining the effectiveness and cost-effectiveness of treatments for depression relative to other physical and mental illness treatments.

A psychotherapeutic approach to severely depressed patients.

Even severely depressed patients respond to psychotherapy. A knowledge of the psychodynamic patterns of the life of depressed patients is required for effective therapy. The psychodynamics and main psychotherapeutic procedures for the treatment of two common types of severe depression are described.