Quality Of Life Enjoyment And Satisfaction Questionnaire-Short Form Research Articles

Abstinence and reduced frequency of use are associated with improvements in quality of life among treatment-seekers with cannabis use disorder.

Many patients with cannabis use disorder (CUD) do not achieve or do not have abstinence as a goal of treatment, rather they reduce their use. Assessing outcome measures as they relate to functioning and reductions in cannabis use is an important area of study. Quality of life (QoL) shows promise as one such measure. Past studies have demonstrated gender differences in QoL and CUD. We aim to assess (1) the relationship between cannabis use and QoL and (2) gender effects in an outpatient medication treatment study for CUD. Data from an 11-weeks, double-blind, placebo-controlled trial of lofexidine and dronabinol for CUD (n = 62) was analyzed. Pearson's correlations between baseline QoL as measured with the Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (QLES-Q-SF) and cannabis use assessed with modified timeline follow-back (TLFB) were examined. Multiple linear regression models of cannabis use on end of study QLES-Q-SF were analyzed, while adjusting for baseline QLES-Q-SF, study arm, and gender. Moderation effects with gender were also tested. No significant association between baseline cannabis use and QoL was found. End of study abstinence (F1,47 = 8.34, p = .006) and reduced proportion of using days (F1,47 = 9.48, p = .004) were each significantly associated with end of study QoL. Reduction in grams (F1,27 = 0.25, p = .62) was not associated with QoL at end of study. Gender was not a significant moderator. Abstinence and lower frequency of use are associated with higher QoL, regardless of gender. This is the first time QoL has been demonstrated to change over the course of CUD medication treatment. QoL is an important outcome in CUD treatment. NCT01020019. (Am J Addict 2018;27:101-107).

RANOLAZINE FOR SYMPTOMATIC MANAGEMENT OF MICROVASCULAR ANGINA IN A CANADIAN SPECIAL ACCESS PROGRAM

Ranolazine is currently approved in the United States and Europe as a second-line agent for chronic stable angina but is available in Canada only through special access (SA). Microvascular angina (MVA) is defined as angina with no obstructive coronary artery disease (< 50% stenosis of a major epicardial artery) and is secondary to impaired vasodilation of arterioles leading to inadequate blood flow. Treatment of MVA consists of standard anti-anginal medications and risk factor management; however, 20-30% of patients remain symptomatic. Our objective was to assess the effectiveness of ranolazine at improving angina scores and quality of life (QOL) in Canadian patients with severe refractory angina due to MVA. We administered questionnaires consisting of the Seattle Angina Questionnaire (SAQ) and the Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form (Q-LES-Q-SF) at baseline and after at least 6 weeks of ranolazine treatment in 31 patients with refractory angina secondary to MVA in the SA program. Refractory angina was defined as Canadian Cardiovascular Society (CCS) >3 angina after at least 2 anti-anginal medication trials. Validated, clinically significant changes for each SAQ domain were obtained from the literature and a Wilcoxon rank test was performed to test the change in scores between baseline and post-ranolazine use. Patients in our cohort were mostly female (27/31 patients) with a median age of 57. At baseline, 48.4% of the patients were on 3 anti-anginal medications. The median length of time on ranolazine at the time of the post-ranolazine questionnaires was 17 weeks. After initiation of ranolazine treatment, patients experienced a significant clinical improvement in Q-LES-Q-SF and in three of the four selected domains of the SAQ except for angina frequency (Table). 73.3% of patients reported improvement in physical limitation (P < 0.001), 80.6% of patients reported improved treatment satisfaction (P < 0.001), 77.4% of patients reported improved disease perception (P = 0.002) and 80.6% of patients had improved Q-LES-Q-SF scores (P < 0.001) compared to baseline. The Figure depicts the average change, as well as each patient’s experience on ranolazine, in three domains of the SAQ. Ranolazine obtained by a SA program in Canada significantly improves symptom control and QOL in patients with MVA and severe refractory angina after at least 6 weeks of use. Given the potentially debilitating effect of chronic angina in MVA, ranolazine is an effective treatment option.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Validation of the clutter image rating (CIR) scale among psychiatric outpatients in Singapore.

BackgroundThe Clutter Image Rating (CIR) Scale though extensively used to assess hoarding behavior, has mainly been validated in Western populations.MethodsThe current study sought to validate the CIR in a sample of psychiatric outpatients (n = 500) in Singapore. Convergent and divergent validity as well as inter-observer reliabilities between participant CIR and interviewer-rated CIR were calculated.ResultsThe CIR performed fairly in identifying participants with and without hoarding problems according to the Savings Inventory Revised (SI-R). The CIR composite demonstrated good convergent validity with the SI-R clutter subscale, the SI-R total and the Activities of Daily Living Scale for Hoarding (ADL-H) scale and discriminant validity with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form (Q-LES-Q-SF) scale.ConclusionsFindings add valuable knowledge to the utility of the CIR in an Asian population.

Health Related Quality of Life after ECT for depression: A study exploring the role of different electrode-placements and pulse-widths

IntroductionPrior research has shown large improvements in HRQOL after a course of ECT for depression. However, the effect of different types of ECT on HRQOL outcomes has not been explored. This is important due to the considerable range of ECT treatment modalities that currently exist in clinical practice. MethodsHRQOL data from 355 depressed patients in three Australian clinical hospitals, who received ECT given with a range of treatment modalities (combinations of pulse-width and electrode-placement), were analysed. HRQOL was measured at baseline and after ECT, using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). The association between type of ECT and HRQOL after ECT was examined by regression analysis, controlling for variables that may affect HRQOL outcomes. ResultsThere was a significant increase in HRQOL scores after ECT (p<0.0001; t=−23.4). The magnitude of change was large (54% increase, Cohen's d=1.43). Multiple regression analysis yielded a significant model (P<0.001, R2=0.18). Baseline HRQOL score (t=4.83; p<0.0001), age (t=2.75, p<0.01) and type of ECT received [Right Unilateral brief vs Bitemporal Ultrabrief (t=−2.99; p<0.01) and Right Unilateral brief vs Bifrontal Ultrabrief (t=−2.70; p<0.01)] were significant predictors of HRQOL after the ECT course. LimitationsData was collected naturalistically from clinical services, thus ECT modality was not randomly assigned. Site could have confounded results. ConclusionsAn acute course of ECT for depression produced statistically and clinically significant improvements in HRQOL. ECT treatment modality can substantially impact HRQOL outcomes, with the possibility of bilateral ultrabrief forms of ECT being less beneficial.

Psychiatric comorbidities in patients with brain tumors after radiotherapy – An intermediate report

IntroductionPrimary or secondary CNS tumors are among the most difficult to manage forms of cancer. Treatment of these tumors remains a challenge in oncology and the success rates for treatment of brain tumors are much lower than in extracerebral localizations. Because most chemotherapeutic agents do not cross the blood-brain barrier effectively and surgery is sometimes only palliative, radiotherapy remains the main method of treatment of these lesions. Both localized and generalized brain radiotherapy have numerous psychiatric complications.ObjectivesThe objective of the study was to assess the psychiatric comorbidities in patients with brain tumors receiving radiotherapy.AimsThis is an intermediate report of a larger study that assesses comorbidities in patients with brain tumors after radiotherapy.MethodsTwenty-five patients with different localization brain tumors were included in this observational study before receiving radiotherapy. All patients were assessed using Hospital Anxiety and Depression Scale (HADS) for anxiety and depressive symptoms, Montreal Cognitive Assessment (MOCA) for cognitive impairment and Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form (Q-LES-Q-SF) at inclusion and after 3 months from finishing the radiotherapy sessions.ResultsTwenty-two patients completed the study. Nine patients received antidepressant treatment (sertraline, tianeptine) during the study for depressive symptoms or anxiety. Patients receiving antidepressants showed better scores on HADS, MOCA and Q-LES-Q-SF scales.ConclusionsAntidepressant use in patients receiving radiotherapy for brain tumors could be neuroprotective and could improve quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Quality of life in Iranian patients with bipolar disorder: a psychometric study of the Persian Brief Quality of Life in Bipolar Disorder (QoL.BD).

To assess the reliability, validity, and factor structure of the Persian Brief Quality of Life in Bipolar Disorder (QoL.BD) in Iranian patients with bipolar disorder (BD). After translation and cross-cultural adaptation of the Brief QoL.BD, we administered the questionnaire to 184 patients diagnosed with BD. To determine factor structure, we performed both exploratory and confirmatory factor analyses. To investigate the reliability, we assessed internal consistency, reproducibility and agreement. Construct validity was assessed by calculating correlations between the Brief QoL.BD and the Short Form-36 (SF-36), Positive And Negative Affect Schedule (PANAS), Hamilton Depression Rating Scale, Young Mania Rating Scale (YMRS) and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). We also investigated gender differences in interpretations of QoL.BD items. The results obtained from reliability analysis confirmed internal consistency (Cronbach's alpha was 0.87 and 0.89 for two assessments) and reproducibility and agreement (the intraclass correlation coefficient ranged between 0.74 and 0.94). Validity analyses showed that the items loaded on a single-factor structure. The inter-item correlations varied from 0.31 to 0.68. Significantly lower scores on the Brief QoL.BD were observed in people diagnosed with BD I compared to BD II. Significant correlations were observed between the Brief QoL.BD and SF-36 summary measures, HAMD, YMRS, Q-LES-Q-SF and PANAS subscales. Items in the Brief QoL.BD were interpreted similarly by men and women. The Brief Persian QoL.BD is a psychometrically sound measure with acceptable validity and reliability and provides a rapid assessment tool for measuring QoL in patients with BD.

Differential item functioning (DIF) of SF-12 and Q-LES-Q-SF items among french substance users.

BackgroundDifferential Item Functioning (DIF) is investigated to ensure that each item displays a consistent pattern of responses irrespective of the characteristics of the respondents. Assessing DIF helps to understand the nature of instruments, to assess the quality of a measure and to interpret results. This study aimed to examine whether the items of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Short-Form 12 (SF-12) exhibit DIF.MethodA total of 124 outpatients diagnosed with substance dependence participated in a cross-sectional, multicenter study. In addition to the Q-LES-Q-SF and SF-12 results, demographic data such as age, sex, type of substance dependence and education level were collected. Rasch analysis was conducted (using RUMM2020 software) to assess DIF of the Q-LES-Q-SF and SF-12 items.ResultsFor SF-12, significant age-related uniform DIF was found in two of the 12 items, and sex-related DIF was found in one of the 12 items. All of the observed DIF effects in SF-12 were found among the mental health items. Three items showed DIF on the Q-LES-Q-SF; however, the impact of DIF item on the delta score calculation for the comparisons of self-reported health status between the groups was minimal in the SF-12 and small in the Q-LES-Q-SF.ConclusionThese results indicated that no major measurement bias affects the validity of the self-reported health status assessed using the Q-LES-Q-SF or SF-12. Thus, these questionnaires are largely robust measures of self-reported health status among substance users.

Health-related Quality of Life in Children With Prune-belly Syndrome and Their Caregivers

To compare health-related quality of life (HRQoL) in children with prune-belly syndrome (PBS) and their caregivers to healthy controls, as children and adolescents with PBS face numerous potential physical and psychosocial challenges. Study participants completed the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL) 4.0 generic core scales (children) or Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) (caregivers) in an online, anonymous format. The PedsQL 4.0 is a 23-item, age-adjusted, validated questionnaire that assesses physical, emotional, social, and school functioning in pediatric patients. The Q-LES-Q-SF is a validated, self-report measure that assesses various areas of daily functioning in adults. PedsQL 4.0 was completed by 32 children with PBS. Individual physical (66.3 ± 20 vs 84.4 ± 17.3; P < .0001), emotional (68.4 ± 23.4 vs 80.9 ± 19.6; P < .01), social (63.1 ± 21.3 vs 87.4 ± 17.2; P < .0001), and school (53 ± 21.7 vs 78.6 ± 20.5; P < .0001) functioning scales were all significantly lower than in healthy children. Nineteen caregivers completed the Q-LES-Q-SF. Caregivers had a mean raw score of 54.8 ± 9.6, which was significantly lower (P = .02) than the comparative healthy adult cohort (59.8 ± 11.3). PBS profoundly impacts HRQoL in children, negatively affecting physical, emotional, social, and school functioning. Caregivers of PBS patients also report an overall lower quality of life, highlighting the challenges that families with chronically ill children often face.

Prevalence of restless legs syndrome in somatoform pain disorder and its effect on quality of life

Background:Persistent somatoform pain disorder (SPD) is a condition in which the patient suffers from persistent, severe and distressing pain; and from associated physical and psychological distress. While presence of restless leg syndrome (RLS) in SPD is understudied, their association might have an impact on general well-being and quality of life (QoL) in SPD.Aims and Objectives:Present study aimed at evaluating the prevalence of RLS in SPD patients attending outpatient department services at a tertiary care institute in eastern India.Materials and Methods:Two hundred and forty consecutive patients with SPD were screened initially and after applying appropriate inclusion and exclusion criteria, 192 subjects (male = 85, female = 107) were included in the study. Severity of RLS was assessed using a questionnaire of the International Restless Legs Syndrome Study Group and QoL was measured on QoL Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results:Revealed a 28% prevalence of RLS is in patients with SPD, which is much higher than its estimated population prevalence. A larger proportion of those with RLS had continuous course of SPD, longer duration of SPD, and higher daytime sleepiness. They also had poorer scores on Q-LES-Q-SF, indicating a poorer QoL overall.Discussion and Conclusion:This is the first report, to the best of our knowledge, on this aspect from India. While this association between RLS and SPD may have biological explanation based on abnormal monoaminergic neurotransmission system, the findings call for more vigilant approach to SPD patients in order to improve their QoL and add to their well-being.

Importance of remission and residual somatic symptoms in health-related quality of life among outpatients with major depressive disorder: a cross-sectional study.

BackgroundMajor depressive disorder (MDD) is strongly associated with an impaired quality of life (QoL), which is itself affected by various factors. Symptom-oriented ratings poorly reflect the impact of disease on the QoL and level of functioning of the mental health of subjects. The purpose of this study was to assess health-related QoL (HRQoL) using preference-based measures in outpatients with MDD with regard to their remission achievement and clinical factors affecting the HRQoL.MethodsThis was a cross-sectional observational study. We recruited 811 patients with MDD from 14 psychiatric outpatient clinics in Korea. They were divided into three groups as follows: a new visit group (n = 287), a remitted group (n = 235), and a non-remitted group (n = 289). The 17-item Hamilton Depression Rating Scale was used to assign patients to the remitted or non-remitted group. The general HRQoL was assessed with the EuroQol 5D (EQ-5D), using both the EQ-5D index score and the EuroQol Visual Analog Scale (EQ-VAS). The disease-specific HRQoL was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF).ResultsThe non-remitted group showed a significant impairment of HRQoL in view of the subscales of EQ-5D index scores, EQ-VAS, and Q-LES-Q-SF. The EQ-5D index score in the remitted group was 0.77 ± 0.10, while it was 0.57 ± 0.23 in the non-remitted group and 0.58 ± 0.24 in the new visit group (p < 0.0001). The EQ-VAS scores for the remitted and non-remitted groups were 72.5 ± 16.6 and 50.9 ± 20.3, respectively (p < 0.0001). Likewise, patients with remission had the Q-LES-Q-SF total score of 46.5 ± 8.8, whereas those with non-remission reported 36.7 ± 7.7 (p < 0.0001). The symptom severity measured by the Depression and Somatic Symptoms Scale was significantly correlated with the HRQoL. Furthermore, patients with severe somatic symptoms showed a significantly lower EQ-5D index score (0.54 ± 0.24) than those with mild/moderate somatic symptoms (0.75 ± 0.12; p = 0.002).ConclusionNon-remitted MDD patients, especially those with more severe somatic symptoms, show a distinct impairment of HRQoL and more clinical symptoms, suggesting the importance of achieving remission in the treatment of MDD.

Combination of classical test theory (CTT) and item response theory (IRT) analysis to study the psychometric properties of the French version of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF).

The study aimed to examine the construct validity and reliability of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) according to both classical test and item response theories. The psychometric properties of the French version of this instrument were investigated in a cross-sectional, multicenter study. A total of 124 outpatients with a substance dependence diagnosis participated in the study. Psychometric evaluation included descriptive analysis, internal consistency, test-retest reliability, and validity. The dimensionality of the instrument was explored using a combination of the classical test, confirmatory factor analysis (CFA), and an item response theory analysis, the Person Separation Index (PSI), in a complementary manner. The results of the Q-LES-Q-SF revealed that the questionnaire was easy to administer and the acceptability was good. The internal consistency and the test-retest reliability were 0.9 and 0.88, respectively. All items were significantly correlated with the total score and the SF-12 used in the study. The CFA with one factor model was good, and for the unidimensional construct, the PSI was found to be 0.902. The French version of the Q-LES-Q-SF yielded valid and reliable clinical assessments of the quality of life for future research and clinical practice involving French substance abusers. In response to recent questioning regarding the unidimensionality or bidimensionality of the instrument and according to the underlying theoretical unidimensional construct used for its development, this study suggests the Q-LES-Q-SF as a one-dimension questionnaire in French QoL studies.

Is the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) a unidimensional or bidimensional instrument?

The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is among the most frequently used outcome measures in psychiatry research [1]. It is a generic, self-reported QOL measure assessing the physical health, subjective feelings, leisure activities, social relationships, general activities, satisfaction with medications and life-satisfaction domains. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LESQ-SF) was developed as an index from the original, long form, fully representing its concept [1, 2]. In the most recent psychometric study, the Chinese version of the Q-LES-Q-SF was evaluated [3]. The authors approached its validity in one new way—studying factorial structure using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). This approach resulted in one interesting finding that the measure has psychosocial and physical dimensions. However, this finding could be biased. First, it is not clear why the authors decided to study the factorial structure of this index measure. Although not clearly stated, they were looking for possible underlying dimensions. However, the authors used principal component analysis (PCA) with varimax rotation for EFA, which is wrong, because PCA is not the method of choice if one wants to discover underlying factors or dimensions [4]. The right method is principal axis factoring, for example, which is essentially factor analysis (FA) [4]. If the goal is data reduction, PCA is more appropriate. In PCA, all variance of observed variables (shared; unique; and error) is analyzed, while in FA only shared variance is analyzed. Thus, PCA yields components and FA gives factors. Nevertheless, it is generally accepted that the difference between FA and PCA decreases when the number of variables and the magnitude of the factor loadings increase [5]. To consider this notion in this particular situation, the authors need to show all item loadings and not only those above 0.4 for the two factors, because some items might cross-load on two factors. Finally, two components were extracted together accounting for 46.47 % of the variance, with the ‘‘psychosocial dimension’’ explaining 37.41 % and the ‘‘physical dimension’’ explaining 9.07 %. The literature varies on how much variance should be explained before the number of components is sufficient, but the majority suggest that the proportion of variance for each extracted component should be 5–10 % as long as the cumulative proportion of variance explained is 70–90 %, although some indicate as little as 50 % of the variance explained is acceptable [6, 7]. Second, the authors used CFA to confirm the bidirectional model they found in the PCA step. It is not clear why the original unidimensional model of 14 items was not tested. The original model might be similar to the bidimensional in terms of data fit, and a statistical approach needs to be taken to decide which one is better. Additionally, these fit indexes were included: included goodness-of-fit index (GFI), adjusted GFI, and the root of the mean square residual. The Tucker Lewis index, Comparative Fit index and root mean square error of approximation were not given, but they are standard nowadays [8]. I advise authors to share with us additional data in order to justify that the Q-LES-Q-SF is a bidimensional instrument. D. Stevanovic (&) Clinic for Neurology and Psychiatry for Children and Youth, Dr. Subotic 6a, 11000 Belgrade, Serbia e-mail: stevanovic.dejan79@gmail.com

Effects of once-daily extended release quetiapine fumarate (quetiapine XR) on quality of life and sleep in elderly patients with major depressive disorder

BackgroundMajor depressive disorder (MDD) is frequently associated with reduced quality of life (QoL) and sleep disturbance. We investigated the effects of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy on QoL and sleep in elderly patients with MDD. MethodsProspectively planned analysis of patient-reported data from an 11-week (9-week randomized; 2-week post-treatment), double-blind, placebo-controlled, Phase III study. Elderly patients (≥66 years; DSM-IV MDD; Hamilton Rating Scale for Depression [HAM-D] total score ≥22, HAM-D Item 1 score ≥2) were randomized to quetiapine XR (flexible dosing 50–300mg/day) or placebo. Primary outcome: MADRS total score change from randomization at Week 9. Patient-reported outcomes: Quality of Life, Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) % of maximum total score (Items 1–14), Q-LES-Q-SF Item 15 (‘satisfaction with medication’), Q-LES-Q-SF Item 16 (‘overall life satisfaction’), and Pittsburgh Sleep Quality Index (PSQI) global score. ResultsIn total, 338 patients were randomized (166 quetiapine XR; 172 placebo). At Week 9, quetiapine XR significantly reduced MADRS total score (−16.33; difference: −7.54; 95% CI: −9.23, −5.85; p<0.001) versus placebo (−8.79). Quetiapine XR significantly improved Q-LES-Q-SF % of maximum total score (16.86; difference: 7.69; 95% CI: 4.99, 10.39; p<0.001) versus placebo (9.17), with numerical improvement in Q-LES-Q-SF Item 15 and improvement in Item 16. Improvement in PSQI global score was observed with quetiapine XR (-6.42; difference: −3.52; 95% CI: −4.26, −2.79; p<0.001) versus placebo (−2.89). LimitationsLack of active-comparator arm, flexible-dose design, acute treatment period. ConclusionsQuetiapine XR monotherapy improved QoL and sleep in elderly patients with MDD.

Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study

While symptoms of deficient emotional self-regulation (DESR) such as low frustration tolerance, temper outbursts, emotional impulsivity, and mood lability are commonly associated with attention deficit hyperactivity disorder (ADHD), little is known about their nature. The main aim of this post hoc study was to examine the correlates of DESR in a large sample of adults with and without ADHD. Subjects were 206 adults with ADHD and 123 adults without ADHD from a family study of ADHD. Emotional impulsivity was operationalized using items from the Barkley Current Behavior Scale. Subjects were comprehensively assessed for psychiatric comorbidity using structured diagnostic interview methodology. We used the Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (QLES-Q-SF) and Social Adjustment Scale-Self-report (SAS-SR) to assess quality of life and psychosocial functioning. DESR was more common among ADHD compared with non-ADHD adults, and 55% of adults with ADHD reported extreme DESR of greater severity than 95% of control subjects. The association of ADHD and DESR was not entirely accounted for by either current or lifetime comorbid disorders. DESR was also associated with significant functional impairment as evaluated by the QLES-Q-SF and SAS-SR, and with reduced marital status, as well as higher risk for traffic accidents and arrests. DESR adversely impacts quality of life in adults with ADHD. More work is needed to further evaluate DESR in clinical and investigational studies of subjects with ADHD.

The Treatment of Depressed Chinese Americans Using Qigong in a Health Care Setting: A Pilot Study

Background. This pilot study examined the feasibility and efficacy of providing Qigong treatment in a health center to Chinese Americans with major depressive disorder (MDD). Methods. Fourteen Chinese Americans with MDD were enrolled, and they received a 12-week Qigong intervention. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression (HAM-D17); the Clinical Global Impressions-Severity (CGI-S) and -Improvement (CGI-I), the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF), and the Multidimensional Scale of Perceived Social Support (MSPSS) were also administered. Positive response was defined as a decrease of 50% or more on the HAM-D17, and remission was defined as HAM-D17 ≤ 7. Patients' outcome measurements were compared before and after the Qigong intervention. Results. Participants (N = 14) were 64% female, with a mean age of 53 (±14). A 71% of participants completed the intervention. The Qigong intervention resulted in a positive treatment-response rate of 60% and a remission rate of 40% and statistically significant improvement, as measured by the HAM-D17, CGI-S, CGI-I, Q-LES-Q-SF, and the family support subscale of the MSPSS. Conclusions. The Qigong intervention provided at a health care setting for the treatment of primary care patients with MDD is feasible. Further studies with larger sample sizes are warranted.

Effects of once-daily extended release quetiapine fumarate on patient-reported outcomes in patients with generalized anxiety disorder.

BackgroundWe evaluated the effects of once-daily extended-release quetiapine fumarate (quetiapine XR) on patient-reported outcomes in generalized anxiety disorder (GAD).MethodsThis is a report of a pooled analysis from three acute 8-week, randomized, placebocontrolled, fixed-dose (50, 150, 300 mg/day) studies and a 52-week maintenance flexible dose (50–300 mg/day) study of quetiapine XR monotherapy in patients with GAD. Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) percent maximum total scores (items 1–14), item 15 (“satisfaction with medication”), item 16 (“overall life satisfaction”), and Pittsburgh Sleep Quality Index (PSQI) global scores are reported. Sheehan Disability Scale (SDS) total scores were also assessed (maintenance study only).ResultsThe acute studies showed significant improvements at week 8 in Q-LES-Q-SF percent maximum total score with quetiapine XR 150 mg/day (P < 0.001) and item 16 with quetiapine XR 50 (P < 0.05) and 150 mg/day (P < 0.001) versus placebo; PSQI global scores significantly improved with quetiapine XR 50, 150, and 300 mg/day versus placebo (P < 0.001). The maintenance study showed significant benefits versus placebo with quetiapine XR 50–300 mg/day in Q-LES-Q-SF percent total score, item 15 and item 16 scores, PSQI global score, and SDS total score.ConclusionQuetiapine XR 150 mg/day (acute studies) and 50–300 mg/day (maintenance study) improved quality of life, overall functioning, and sleep quality in patients with GAD.

PW01-11 - Effect of adjunctive aripiprazole on quality of life in patients with major depressive disorder: pooled data from three clinical trials

IntroductionAssessing impact of treatment from the patient perspective provides additional information about treatment efficacy in major depressive disorder (MDD) trials.ObjectivesPooled data from three identically designed clinical trials showed aripiprazole adjunctive to antidepressant therapy (ADT) was effective in treating MDD.1MethodsPatients who completed an 8-week prospective ADT phase with inadequate response were randomized double-blind to 6-weeks adjunctive treatment with aripiprazole or placebo. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is a 16-item, self-report measure to evaluate daily functioning, with higher scores indicating better satisfaction. Comparisons of mean change from baseline (Week 8) to Week 14 in Q-LES-Q-SF items and general subscores were performed using ANCOVA (LOCF).ResultsThere was significant improvement in the Q-LES-Q-SF Overall-General subscore (total of items 1-14 expressed as a percentage of the maximum possible score) in the aripiprazole-treatment group (9.49% [n=507]) vs placebo (5.71% [n=492] p&lt; 0.001). Placebo was significantly higher than aripiprazole in Physical Ability (placebo 0.13 vs aripiprazole 0.02, p=0.020). Aripiprazole was significantly higher than placebo in all other items except Physical Health and Vision. Aripiprazole also produced significant increases in both the Satisfaction with Medication (Item 15) (aripiprazole 0.36 vs placebo 0.20, p&lt; 0.01) and Overall Satisfaction (Item 16) (aripiprazole 0.61 vs placebo 0.35, p&lt; 0.001) scores.ConclusionsResults emphasize that assessment of patient functioning and quality of life may have utility both in clinical trials and clinical practice.2

Psychophysical Aspects of Hidradenitis Suppurativa

Hidradenitis suppurativa is a recurrent, debilitating suppurative skin disease. The symptoms are much more than just physical, but studies of its impact on patients' psychological state and related quality of life are very limited. The current study was conducted with a group of 54 patients, aged 16-65 years, who had an active, but stable, course of hidradenitis suppurativa. The aim of the study was to determine the influence of hidradenitis suppurativa on a broad spectrum of psychophysical factors. Assessment was carried out using several questionnaires, which revealed the following mean scores: Dermatology Life Quality Index (DLQI) (12.67 +/- 7.7), Beck Depression Inventory-Short Form (BDI-SF) (5.87 +/- 4.68), Evers et al. "6-Item Scale" (3.87 +/- 3.65), EQ-5D (0.66 +/- 0.23 (health index) and 56.78 +/- 18.84 (VAS)), Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F) (32.06 +/- 11.01) and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) (56.44 +/- 15.17%). The results highlight the important impact of hidradenitis suppurativa on a wide spectrum of psychophysical aspects and impairment of related quality of life among patients. Our findings indicate that advancement of the disease seems to be the most important factor negatively influencing patients' well-being (p < 0.01). It is noteworthy that an anogenital location appears to impair the hidradenitis suppurativa patients' quality of life most of all (p < 0.05), but the occurrence of lesions on uncovered skin plays a crucial role in the stigmatization level (p < 0.05).

Quality of life in depression: An important outcome measure in an outpatient cognitive–behavioural therapy group programme?

Studies have shown that psychiatric patients have significantly impaired quality of life (QOL) in comparison to community samples who are not suffering a mental illness. Despite an increase in research in the mental health field, there still remains little consensus as to the merit of using such questionnaires within a mental health population. There is a concern that QOL is redundant with affective state and symptomatology. We investigated the usefulness of the Quality of Life Enjoyment and Satisfaction Questionnaire-short form (QLESQ-SF) in a depressed outpatient sample receiving time-limited, standardized group cognitive-behavioural therapy. QLESQ-SF ratings were examined at admission and 10-week endpoint in an intention-to-treat (N = 212) and completers (N = 164) sample. QLESQ-SF ratings and symptom ratings (Beck Depression Inventory-II; Beck Anxiety Inventory) improved significantly over time. Hierarchical regression analyses revealed that, although affective state and change in symptomatology were significantly correlated with QOL and change in QOL, a large proportion of variance was unexplained. These results are inconsistent with the theory of measurement redundancy. QOL appears to be a useful measure that provides additional treatment outcome information distinct from affective state and symptomatology.

Health-related quality of life and utilities in primary-care patients with generalized anxiety disorder

Generalized anxiety disorder (GAD) is prevalent and significantly impacts patient health-related quality of life (HRQL) and disability. This study evaluated the effect of GAD and anxiety symptom severity on the HRQL of primary-care patients with GAD. Patients 18 years or older with GAD were recruited from an integrated health care delivery system. Clinical assessments included the Hamilton Anxiety Rating Scale (HAM-A), GAD Questionnaire-IV (GAD-Q-IV), and the Patient Health Questionnaire depression module (PHQ). HRQL was assessed by the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), Sheehan Disability Scale (SDS), SF-12 Health Survey (SF-6D), and the Health Utilities Index (HUI2, HUI3). The sample included 297 patients, 72% women with mean +/- standard deviation (SD) age of 47.6 +/- 13.7 years. At baseline, the mean HAM-A score was 16.8 +/- 7.6 (suggesting the presence of moderate anxiety symptoms). Anxiety and depression symptoms were significantly correlated with mental component summary (MCS), Q-LES-Q-SF, SDS, SF-6D, HUI2, and HUI3 scores (all P < 0.001). The mean HRQL and all of the preference-based measures varied significantly by anxiety severity groups (all P < 0.001). Anxiety and depression symptoms significantly predicted HRQL and preference-based scores (R(2) values ranged from 0.22 to 0.57). Anxiety symptoms reported by GAD patients resulted in significant impairment to HRQL and functional outcomes.