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Depression and Quality of Life Among Depressed Brazilian Outpatients

2003; American Psychiatric Association; Volume: 54; Issue: 2 Linguagem: Inglês

10.1176/appi.ps.54.2.254

1557-9700

Marcelo T. Berlim, Betina S. Mattevi, Marcelo P. Fleck,

Child and Adolescent Psychosocial and Emotional Development

Back to table of contents Previous article Next article LettersFull AccessDepression and Quality of Life Among Depressed Brazilian OutpatientsMarcelo T. Berlim, M.D., Betina S. Mattevi, M.D., and Marcelo P. A. Fleck, M.D., Ph.D.Marcelo T. Berlim, M.D., Betina S. Mattevi, M.D., and Marcelo P. A. Fleck, M.D., Ph.D.Published Online:1 Feb 2003https://doi.org/10.1176/appi.ps.54.2.254AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Current research on the impact of depressive disorders should include studies that seek to determine how these disorders influence the quality of life of depressed persons (1,2). Studies have shown that people who are depressed have deficits in their quality of life that are directly attributable to the mood disturbance and that the degree of the decrement is proportional to the severity of depression (2,3). However, these studies have been done almost entirely in English-speaking populations.We conducted a study to assess all newly diagnosed depressed patients aged 18 to 75 years (N=43) who attended the mood disorders clinic of a Brazilian university hospital between March and October 2001. The study was approved by the hospital's ethics committee. The patients in the sample were administered the cross-culturally validated versions of the World Health Organization's Quality of Life Instrument-Short Form (WHOQOL-BREF) (4) and the Beck Depression Inventory (BDI) (5). Possible BDI scores range from 0 to 63, with higher scores indicating more severe depression.The mean±SD age of the patients was 49.5±12.1 years. The group consisted of 39 women (91 percent) and four men (9 percent). Of these, 35 (81 percent) were Caucasians and eight (19 percent) were African Brazilians. Twenty-five (58 percent) were married, and 39 (91 percent) had at least a high school education. Diagnoses were as follows: major depression, 32 patients (74 percent); dysthymia, six patients (14 percent); and bipolar depression, five patients (12 percent). Thirty-three patients (78 percent) had at least one comorbid axis I diagnosis. No significant differences in WHOQOL-BREF and BDI scores were found on the basis of these sociodemographic variables.The patients were severely depressed; the mean BDI score for the sample was 31.16±8.52. Analyses using Pearson's coefficient showed a significant inverse correlation between the BDI score and scores on all WHOQOL-BREF domains: physical health, r=-.325, p=.033; psychological status, r=-.519, p<.001; social relationships, r=-.423, p=.005; environment, r=-.414, p=.006; and the overall measure of quality of life, r=-.322, p=.035. Further analysis with unpaired t tests showed that the 26 patients who were more severely depressed (a BDI score greater than 29) experienced significantly worse quality of life in all WHOQOL-BREF domains than the patients with mild or moderate depression.Our study had several limitations, particularly the small sample and the uncertainty of the extent to which our results can be generalized to community samples. In addition, both the quality of life and depression measures depend on patients' self-reports. Nevertheless, these measures have been validated in several studies, and we believe that they are a reasonably accurate gauge of patient discomfort. Future studies are needed to replicate our findingsOur findings suggest that the WHOQOL-BREF is a sensitive indicator of morbidity and the severity of depressive disorders and that as symptoms of depression increase among Brazilian depressed patients, the patients' quality of life significantly decreases.The authors are affiliated with the department of psychiatry and forensic medicine at the Universidade Federal do Rio Grande do Sul in Porto Alegre, Rio Grande do Sul, Brazil.References1. Sartorius N: The economic and social burden of depression. Journal of Clinical Psychiatry 62(suppl 15):8-11, 2001Medline, Google Scholar2. Demyttenaere K, Fruyt JD, Huygens R: Measuring quality of life in depression. Current Opinion in Psychiatry 15:89-92, 2002Crossref, Google Scholar3. Fleck MPA, Louzada S, Xavier M, et al: Application of the Portuguese version of the abbreviated instrument of quality of life (WHOQOL-BREF) [in Portuguese]. Revista de Saúde Pública 34:178-183, 2000Crossref, Medline, Google Scholar4. Gorenstein C, Andrade LH: Beck depression Inventory: psychometric properties of the Brazilian version [in Portuguese]. Revista Psiquiatria Clínica (São Paulo) 25:245-250, 1998Google Scholar5. Skevington SM, Wright A: Changes in the quality of life of patients receiving antidepressant medication in primary care: validation of the WHOQOL-100. British Journal of Psychiatry 178:261-267, 2001Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited byBMC Public Health, Vol. 14, No. 1Spirituality and subjective wellbeing in patients with lower-limb ulcerationJournal of Wound Care, Vol. 22, No. 5Journal of Affective Disorders, Vol. 150, No. 2Cadernos de Saúde Pública, Vol. 29, No. 7Quality of Life: The Ultimate Outcome Measure of Interventions in Major Depressive DisorderHarvard Review of Psychiatry, Vol. 19, No. 5Archives of Gerontology and Geriatrics, Vol. 53, No. 1Revista de Saúde Pública, Vol. 45, No. 1Can sociodemographic and clinical variables predict the quality of life of outpatients with major depression?Psychiatry Research, Vol. 160, No. 3Factors related to quality of life in depressive outpatients in Taiwan7 December 2007 | Psychiatry and Clinical Neurosciences, Vol. 61, No. 6Psychiatry Research, Vol. 153, No. 3Quality of Life and Major DepressionJournal of Psychosomatic Research, Vol. 61, No. 5Psychiatry Research, Vol. 144, No. 2-3Quality of Life Research, Vol. 14, No. 2 Volume 54Issue 2 February 2003Pages 254-254 Metrics History Published online 1 February 2003 Published in print 1 February 2003