Validation of the Depression and Somatic Symptoms Scale by comparison with the Short Form 36 scale among psychiatric outpatients with major depressive disorder

Abstract Introduction Many individuals with major depressive disorder (MDD) do not respond to initial antidepressant monotherapy. Adjunctive aripiprazole is recommended for treatment non-response; however, the impacts on quality of life (QoL) for individuals who receive this second-line treatment strategy have not been described. Methods We evaluated secondary QoL outcomes in patients with MDD (n=179). After 8 weeks of escitalopram, non-responders (<50% decrease in clinician-rated depression) were treated with adjunctive aripiprazole for 8 weeks (n=97); responders continued escitalopram (n=82). A repeated-measures ANOVA evaluated change in Quality of Life Enjoyment and Satisfaction Short Form scores. QoL was described relative to normative benchmarks. Results Escitalopram responders experienced the most QoL improvements in the first treatment phase. For non-responders, QoL improved with a large effect during adjunctive aripiprazole treatment. At the endpoint, 47% of patients achieving symptomatic remission still had impaired QoL. Discussion Individuals who were treated with adjunctive aripiprazole after non-response to escitalopram experienced improved QoL, but a substantial degree of QoL impairment persisted. Since QoL deficits may predict MDD recurrence, attention to ways to support this outcome is required.

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The impacts of migraine, anxiety disorders, and chronic depression on quality of life in psychiatric outpatients with major depressive disorder

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2008.04.011 ◽

2008 ◽

Vol 65 (2) ◽

pp. 135-142 ◽

Cited By ~ 25

Author(s):

Ching-I Hung ◽

Shuu-Jiun Wang ◽

Ching-Hui Yang ◽

Chia-Yih Liu

Keyword(s):

Quality Of Life ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Chronic Depression ◽

Psychiatric Outpatients ◽

Major Depressive

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A simpler definition of major depressive disorder

Psychological Medicine ◽

10.1017/s0033291709990572 ◽

2009 ◽

Vol 40 (3) ◽

pp. 451-457 ◽

Cited By ~ 26

Author(s):

M. Zimmerman ◽

J. N. Galione ◽

I. Chelminski ◽

J. B. McGlinchey ◽

D. Young ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Somatic Symptoms ◽

Structured Interview ◽

Major Depressive ◽

Medically Ill ◽

Treatment Providers ◽

Dsm Iv ◽

Definition Of ◽

High Level

BackgroundThe DSM-IV symptom criteria for major depressive disorder (MDD) are somewhat lengthy, with many studies showing that treatment providers have difficulty recalling all nine symptoms. Moreover, the criteria include somatic symptoms that are difficult to apply in patients with medical illnesses. In a previous report, we developed a briefer definition of MDD that was composed of the mood and cognitive symptoms of the DSM-IV criteria, and found high levels of agreement between the simplified and full DSM-IV definitions. The goal of the present study was to replicate these findings in another large sample of psychiatric out-patients and to extend the findings to other patient samples.MethodWe interviewed 1100 psychiatric out-patients and 210 pathological gamblers presenting for treatment and 1200 candidates for bariatric surgery. All patients were interviewed by a diagnostic rater who administered a semi-structured interview. We inquired about all symptoms of depression for all patients.ResultsIn all three samples high levels of agreement were found between the DSM-IV and the simpler definition of MDD. Summing across all 2510 patients, the level of agreement between the two definitions was 95.5% and the κ coefficient was 0.87.ConclusionsAfter eliminating the four somatic criteria from the DSM-IV definition of MDD, a high level of concordance was found between this simpler definition and the original DSM-IV classification. This new definition offers two advantages over the current DSM-IV definition – it is briefer and it is easier to apply with medically ill patients because it is free of somatic symptoms.

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