Background: Depressive disorders are known to impair health-related
quality of life (HRQoL) both in the short and long term. However, the
determinants of long-term HRQoL outcomes in primary care patients with
depressive disorders remain unclear.



Methods: In a primary care cohort study of patients with depressive
disorders, 82% of 137 patients were prospectively followed up for five
years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II
interviews; clinical, psychosocial and socio-economic factors were
investigated by rating scales and questionnaires plus medical and
psychiatric records. HRQoL was measured with the generic 15D instrument
at baseline and five years, and compared with an age-standardized
general population sample (n = 3707) at five years.



Results: Depression affected the 15D total score and almost all
dimensions at both time points. At the end of follow-up, HRQoL of
patients in major depressive episode (MDE) was particularly low, and the
association between severity of depression (Beck Depression Inventory
[BDI]) and HRQoL was very strong (r = -0.804). The most significant
predictors for change in HRQoL were changes in BDI and Beck Anxiety
Inventory (BAI) scores. The mean 15D score of depressive primary care
patients at five years was much worse than in the age-standardized
general population, reaching normal range only among patients who were
in clinical remission and had virtually no symptoms.



Conclusions: Among depressive primary care patients, presence of
current depressive symptoms markedly reduces HRQoL, with symptoms of
concurrent anxiety also having a marked impact. For HRQoL to normalize,
current depressive and anxiety symptoms must be virtually absent. (C)
2016 Elsevier Masson SAS. All rights reserved.