scholarly journals Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care

2011 ◽  
Vol 33 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Ana Flávia Barros da Silva Lima ◽  
Marcelo Pio de Almeida Fleck
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Major Depression ◽  
Antidepressant Treatment ◽  
Epidemiologic Studies ◽  
World Health ◽  
World Health Organization Quality

OBJECTIVE: To describe the demographic and clinical characteristics, adequacy of antidepressant treatment, and changes in quality of life of patients with major depression receiving follow-up care from primary care centers. METHOD: A cohort study was performed in which major depression patients were followed-up over a nine-month period. Several evaluation instruments were used, including the World Health Organization Quality of Life and the Quality of Life-Depression, Centers for Epidemiologic Studies-Depression questionnaires. RESULTS: The sample comprised 179 individuals, mostly female (73%), with a mean age of 38 years and mean education of 9 years. At the end of the follow-up period, 42% of the individuals still presented with major depression, 25% had complete symptom remission, and only 9% were properly treated with antidepressants. In relation to quality of life, there were significant differences especially between baseline and after nine months in almost all measures. CONCLUSION: This study demonstrated that depressive symptoms are poorly recognized and that treatment is often inadequate for patients followed-up in primary care units in the south of Brazil. Most of the patients continued to have symptoms of depression over the nine-month period which were associated with impaired quality of life.

scholarly journals Major depression and its correlates in primary care settings in six countries

2005 ◽  
Vol 186 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Marcelo Pio De Almeida Fleck ◽  
Gregory Simon ◽  
Helen Herrman ◽  
Donald Bushnell ◽  
Mona Martin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Logistic Regression ◽  
Major Depression ◽  
Complete Remission ◽  
Life Events ◽  
Scale Score ◽  
Depression Scale

BackgroundFew published studies address depression outcomes in primary care from a cross-cultural perspective.AimsTo define baseline factors associated with 9-month clinical outcome: across six countries.MethodAdults meeting criteria for current major depression were recruited from primary care clinics in Australia, Brazil, Israel, Spain, Russia and the USA; 968 patients were assessed at the 9-month follow-up. Predictors of complete remission were examined using logistic regression with a hierarchical model.ResultsRates of complete remission in the six sites ranged from 25% to 48%. Logistic regression using pooled data showed that education, key life events and the Quality of Life Depression Scale score at baseline were the final predictors of complete remission, adjusting for centres, socio-demographic data, severity of depression, comorbidity and general quality of life. Variation in predictors across sites was not statistically significant.ConclusionsThe two major findings of this study were the low proportion of people achieving complete remission at follow-up across the six sites, and that some baseline characteristics (education, Quality of Life Depression Scale score and key life events) are modest predictors of outcome in depression.

scholarly journals Bevacizumab Combined with Corticosteroids Does Not Improve the Clinical Outcome of Nasopharyngeal Carcinoma Patients With Radiation-Induced Brain Necrosis

2021 ◽  
Vol 11 ◽  
Author(s):  
Honghong Li ◽  
Xiaoming Rong ◽  
Weihan Hu ◽  
Yuhua Yang ◽  
Ming Lei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
World Health ◽  
World Health Organization Quality ◽  
Brain Necrosis ◽  
Radiation Induced

ObjectiveOur aim was to compare the clinical outcomes of patients treated with bevacizumab combined with corticosteroids and those with bevacizumab monotherapy from a radiation-induced brain necrosis (RN) registry cohort (NCT03908502).MethodsWe utilized clinical data from a prospective RN registry cohort (NCT03908502) from July 2017 to June 2020. Patients were considered eligible if they had symptomatic RN after radiotherapy for nasopharyngeal carcinoma (NPC) and received bevacizumab (5 mg/kg, two to four cycles) with a minimum follow-up time of 3 months. The primary outcome was a 2-month response rate determined by MRI and clinical symptoms. Secondary outcomes included quality of life [evaluated by the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire] and cognitive function (evaluated by the Montreal Cognitive Assessment scale) at 2 months, RN recurrence during follow-up, and adverse events.ResultsA total of 123 patients (34 in the combined therapy group and 89 in the monotherapy group) were enrolled in our study with a median follow-up time of 0.97 year [interquartile range (IQR) = 0.35–2.60 years]. The clinical efficacy of RN did not differ significantly between patients in these two groups [odds ratio (OR) = 1.642, 95%CI = 0.584–4.614, p = 0.347]. Furthermore, bevacizumab combined with corticosteroids did not reduce recurrence compared with bevacizumab monotherapy [hazard ratio (HR) = 1.329, 95%CI = 0.849–2.079, p = 0.213]. The most common adverse events of bevacizumab were hypertension (17.89%), followed by nosebleed (8.13%) and fatigue (8.13%). There was no difference in grade 2 or more severe adverse events between the two groups (p = 0.811).InterpretationOur results showed that the treatment strategy of combining bevacizumab with corticosteroids did not lead to better clinical outcomes for RN patients with a background of radiotherapy for nasopharyngeal carcinoma.

scholarly journals The Effects of a Mindfulness Meditation Program on Quality of Life in Cancer Outpatients: An Exploratory Study

2017 ◽  
Vol 17 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Yu-Yun Chang ◽  
Li-Yu Wang ◽  
Chia-Yu Liu ◽  
Tsai-Ju Chien ◽  
I-Ju Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Exploratory Study ◽  
Mindfulness Meditation ◽  
Asian Population ◽  
World Health ◽  
World Health Organization Quality ◽  
Significant Difference

Objective. Numerous studies have investigated the efficacy of mindfulness meditation (MM) in managing quality of life (QoL) in cancer populations, yet only a few have studied the Asian population. The aim of this exploratory study is to evaluate the effect of a MM program on the QoL outcomes in Taiwanese cancer outpatients. Methods. Patients with various cancer diagnoses were enrolled and assigned to the MM group and usual care (UC) group. The meditation intervention consisted of 3 sessions held monthly. The outcomes of the whole intervention were measured using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Results. A total of 35 participants in the MM group and 34 in the UC group completed the study. The results showed that the postintervention scores were significantly higher than the preintervention scores in the MM group. In the UC group, there was no significant difference between preintervention and postintervention scores, except for the lower environment domain scores. There was no significant difference between the follow-up scores and postintervention scores in the MM group, indicating that improvement can be maintained for 3 months after completing the MM course. Conclusions. The present study provides preliminary outcomes of the effects on the QoL in Taiwanese cancer patients. The results suggest that MM may serve as an effective mind–body intervention for cancer patients to improve their QoL, and the benefits can persist over a 3-month follow-up period. This occurred in a diverse cancer population with various cancer diagnoses, strengthening the possibility of general use.

Mind–Body Therapy via Videoconferencing in Patients With Neurofibromatosis: Analyses of 1-Year Follow-up

2020 ◽  
Author(s):  
Ethan G Lester ◽  
Melissa V Gates ◽  
Ana-Maria Vranceanu
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Controlled Trial ◽  
Genetic Disorder ◽  
World Health ◽  
Placebo Control ◽  
World Health Organization Quality ◽  
Sustained Improvement

Abstract Background Neurofibromatosis (NF) is a rare genetic disorder associated with substantial deficits in quality of life (QoL). We have previously shown that in this population the Relaxation Response Resiliency Program for NF (3RP-NF) delivered via live videoconferencing is associated with sustained improvement in QoL from baseline through 6-month follow-up over and above an attention placebo control.. Purpose To examine between- and within-group changes in QoL domains from baseline to 1-year follow-up and 6-month to 1-year follow-up. Methods We enrolled and randomized 63 adults with NF. Of these, 52 completed the 6-month follow-up and 53 completed 1-year follow-up. We assessed QoL with the World Health Organization Quality of Life—Brief. Results Participation in the 3RP-NF was associated with sustained improvement from baseline to 1 year in physical health QoL (12.68; 95% confidence interval [CI]: 1.76 to 23.59; p =.024) and social relations QoL (16.81; 95% CI: 3.03 to 30.59; p =.018) but not psychological and environmental QoL, over and above the control (between group changes). Participants in the 3RP-NF improved from baseline to 1 year in psychological (8.16; 95% CI: 1.17 to 15.14; p =.023) and social relations QoL (9.93; 95% CI: 1.10 to 18.77; p = .028; within-group changes). There were no other significant differences between or within groups from baseline/6 months to 1 year. Conclusions The live video 3RP-NF shows promise in improving QoL dimensions over the course of 1 year. Results should be replicated in a fully powered randomized controlled trial. Clinical Trial information ClinicalTrials.gov NCT03406208.

scholarly journals Repetitive Transcranial Magnetic Stimulation Improves Depressive Symptoms and Quality of Life of Poststroke Patients—Prospective Case Series Study

2019 ◽  
Vol 11 ◽  
pp. 117957351987130
Author(s):  
Hercílio Barbosa da Silva Júnior ◽  
Marcos Rassi Fernandes ◽  
Ângela Maria Costa Souza
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Case Series ◽  
World Health ◽  
World Health Organization Quality

Background: Poststroke depression (PSD) is a serious psychiatric complication often reported after a stroke. Nearly a third of stroke survivors experience depressive symptoms at some point, affecting their functional recovery and quality of life. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been studied by many researchers and found to be a safe supporting tool for the treatment of PSD. Objective: We aim to evaluate the effects of rTMS on PSD and on the quality of life of poststroke patients. Method: A prospective clinical case series, performed at CRER Rehabilitation, Brazil, between June 2016 and May 2017. A nonprobabilistic sample (n = 15) was divided into 2 groups (excitatory stimulation in F3, n = 8; inhibitory stimulation in F4, n = 7) and underwent 20 sessions of rTMS. Individuals were assessed according to the 17-item Hamilton Depression Rating Scale (HAM-D17) and World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) questionnaire at 3 different moments: baseline, at the end of the treatment, and in a 1-month follow-up meeting. Results: Both groups presented a significant change in the score of all WHOQOL-BREF domains and in HAM-D17. In the group that received inhibitory stimulation (F4), score changes were continuous and gradual, comparing the 3 moments. In the excitatory stimulated (F3) group, however, the improvement in scores was more expressive between baseline and the second moment, without significant changes in the follow-up. Conclusions: The findings of this clinical study suggest that rTMS can be a promising tool, capable of relieving depressive symptoms and helping in the improvement of poststroke patients’ quality of life.

scholarly journals Testing the Effectiveness of Implementing a Model of Mental Healthcare Involving Trained Lay Health Workers in Treating Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part II Results

2019 ◽  
Vol 64 (9) ◽  
pp. 630-637
Author(s):  
Ashok Malla ◽  
Mushtaq Margoob ◽  
Srividya Iyer ◽  
Abdul Majid ◽  
Shalini Lal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young People ◽  
Mental Disorders ◽  
Rural Setting ◽  
World Health ◽  
World Health Organization Quality ◽  
Middle Income ◽  
Service Engagement

Objectives: To report the outcomes of young people (aged 14-30 years) treated for major mental disorders in a lay health worker (LHW) intervention model in a rural district of conflict-ridden Kashmir, India. Methods: Over a 12-month follow-up, LHWs collected data on symptoms, functioning, quality of life and disability, and patients’ and families’ service engagement and satisfaction. Results: Forty trained LHWs (18 males and 22 females) identified 262 individuals who met the criteria for a diagnosis of a major mental disorder, connected them with specialists for treatment initiation (within 14 days), and provided follow-up and support to patients and families. Significantly more patients (14-30 years) were identified during the 14 months of the project than those in all age groups in the preceding 2 years. At 12 months, 205 patients (78%) remained engaged with the service and perceived it as very helpful. Repeated measures ANOVA showed significant improvements in scores on the global assessment of functioning (GAF) scale (F[df, 3.449] = 104.729, p < 0.001) and all 4 domains of the World Health Organization quality of life (WHOQOL) brief version (WHOQOL-BREF) of the survey—Physical F(df, 1.861) = 40.82; Psychological F(df, 1.845) = 55.490; Social F(df, 1.583) = 25.189; Environment F(df, 1.791) = 40.902, all ps < 0.001—and a decrease in disability (F[df, 1.806] = 4.364, p = 0.016). An interaction effect between time and sex was observed for the physical health domain of the WHOQOL-BREF. Discussion and Conclusions: Our results show that an LHW-based service model, implemented in a rural setting of a low-to-middle income region plagued by long-term conflict, benefits young people with major mental disorders. We discuss the implications of our findings in the context of similar environments and the challenges encountered.

scholarly journals Changes in the quality of life of patients receiving antidepressant medication in primary care: Validation of the WHOQOL–100

2001 ◽  
Vol 178 (3) ◽  
pp. 261-267 ◽  
Author(s):  
Suzanne M. Skevington ◽  
Anne Wright
Keyword(s):  
Quality Of Life ◽  
Antidepressant Treatment ◽  
Antidepressant Medication ◽  
Life Assessment ◽  
World Health ◽  
World Health Organization Quality ◽  
Organization Quality ◽  
Health Organization ◽  
The Uk

BackgroundThe study arises from the need for good quality of life (QOL) assessment and a new comprehensive generic QOL profile for cross-cultural use.AimsTo examine changes in the QOL of patients receiving antidepressants from a general practitioner, and to assess the validity and sensitivity of a new QOL measure, the World Health Organization Quality of Life Assessment (100-item version) (WHOQOL–100).MethodPatients with moderate depression (n=106) completed the WHOQOL–100 and Beck Depression Inventory at the start of treatment and again after 6 weeks.ResultsDepression decreased significantly over 2 months and 74% reported feeling better. WHOQOL–100 scores increased in 24 of the 25 facets, demonstrating that QOL improves significantly in the 8 weeks following the start of antidepressant treatment. It also shows the instrument's validity and sensitivity to changes in clinical condition.ConclusionsThe UK WHOQOL–100 is confirmed as excellent to good. Antidepressants significantly and comprehensively improve QOL.

scholarly journals Validity of the Brazilian version of WHOQOL-BREF in depressed patients using Rasch modelling

2009 ◽  
Vol 43 (1) ◽  
pp. 147-153 ◽  
Author(s):  
Neusa Sica da Rocha ◽  
Marcelo Pio de Almeida Fleck
Keyword(s):  
Quality Of Life ◽  
Major Depression ◽  
Rasch Analysis ◽  
Care Service ◽  
Depression Scale ◽  
World Health ◽  
World Health Organization Quality ◽  
Rasch Modelling ◽  
Brazilian Version

OBJECTIVE: To assess the validity of the Brazilian version of the World Health Organization Quality of Life Instrument - Abbreviated version (WHOQOL-BREF) in adults with major depression, using Rasch modelling. METHODS: Study analyzing data from the baseline sample of the Longitudinal Investigation of Depression Outcomes in Brazil, including a total of 208 patients with major depression recruited in a primary care service in Porto Alegre (Southern Brazil), in 1999. The Center for Epidemiological Studies Depression Scale was used to assess intensity of depression; the WHOQOL-BREF to assess generic quality of life; and the Composite International Diagnostic Interview version 2.1 for the diagnosis of depression. RESULTS: In the Rasch analysis, the four domains of WHOQOL-BREF showed appropriate fit to this model. Some items needed adjustments: four items were rescored (pain, finances, services, and transport); two items (work and activity) were identified as having dependency of responses, and one item was deleted (sleep) due to multidimensionality. CONCLUSIONS: The validation of the WHOQOL-BREF Brazilian version using Rasch analysis complements previous validation studies, evidencing the robustness of this instrument as a generic cross-cultural quality of life measure.

scholarly journals Resilience, Cardiological Outcome, and Their Correlations With Anxious-Depressive Symptoms and Quality of Life in Patients With an Implantable Cardioverter Defibrillator

2021 ◽  
Vol 12 ◽  
Author(s):  
Celeste Isella ◽  
Alessandra Gasparini ◽  
Giulia Lucca ◽  
Marta Ielmini ◽  
Ivano Caselli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Implantable Cardioverter Defibrillator ◽  
Protective Factor ◽  
World Health ◽  
Cardiac Events ◽  
World Health Organization Quality ◽  
Cardioverter Defibrillator

Background: Resilience is proven as a protective factor against the development of psychiatric disorders, and it has gained clinical relevance in the development and progression of cardiovascular pathology. The authors performed a longitudinal study on patients with implantable cardioverter defibrillator (ICD) with the primary aim to highlight the possible existence of a correlation between individual resilience capacity, depressive and anxiety symptoms, and quality of life in terms of outcomes. The secondary aim was to analyze the differences between patients with major cardiac events in the follow-up and patients without cardiac events with respect to the previous variables.Materials and Methods: A total of 80 patients enrolled in the Cardiology Unit were evaluated at T0 and during the follow-up through the following scales: the 14-item Resilience Scale (RS-14), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-Bref).Results: A significant linear correlation between resilience and all the areas of quality of life at T0, T1, and T2 emerged. A negative correlation between resilience and anxiety and depressive symptoms emerged, as well as between depression and anxiety and quality of life. Patients with cardiac events during the follow up have shown a worse quality of life and the onset of anxiety-depressive symptoms over time, without changes to the resilience scores. Patients without cardiac events showed an increasing trend in resilience scores.Discussion: Given the speed and simplicity of use of the RS-14 scale, it seems promising to further investigate the real clinical usefulness of this instrument in the cardiology field.

scholarly journals Hubungan antara Depresi dengan Kualitas Hidup pada Ibu Hamil Berisiko Tinggi

2017 ◽  
Vol 4 (2) ◽  
pp. 206
Author(s):  
Rizky Fauzy ◽  
Endang Fourianalistyawati
Keyword(s):  
Quality Of Life ◽  
World Health Organization ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
World Health ◽  
World Health Organization Quality ◽  
Organization Quality ◽  
Health Organization

Kehamilan risiko tinggi (risti) adalah suatu kehamilan yang memiliki ancaman  lebih besar dari biasanya seperti terjadi penyakit atau kecacatan bahkan kematian sebelum maupun sesudah persalinan. Kondisi kehamilan dengan risiko membuat penderita lebih rentan mengalami gangguan psikologis salah satunya adalah depresi.  Hal tersebut terjadi karena berbagai hal seperti,  kekhawatiran akan keselamatan janin, ancaman kematian yang lebih besar dan keterbatasan dalam beraktivitas. Tantangan yang lebih besar saat menjalani kehamilan juga dapat mempengaruhi kualitas hidup yaitu, persepsi individu mengenai keberfungsian mereka dalam  kehidupan.  Salah satu faktor yang menyebabkan individu memiliki kualias hidup yang buruk yaitu ketika individu mengalami gangguan psikologis berupa depresi. Penelitian ini bertujuan untuk melihat hubungan depresi dengan kualitas hidup pada ibu hamil berisiko tinggi. Subjek dalam penelitian ini adalah 105 orang ibu hamil berisiko tinggi yang berada di Jakarta Timur. Penelitian ini menggunakan alat ukur <em>Center for</em> <em>Epidemiologic Studies Depression Scale</em> (CESD-R) dan <em>World Health Organization Quality of Life-Bref (WHOQOL-BREF)</em> yang sudah diadaptasi oleh peneliti. Uji hipotesis menunjukkan bahwa depresi berhubungan secara signifikan pada setiap dimensi kualitas hidup.

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