Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 10/2010

01-10-2010 | Original Paper

Depression as a determinant of quality of life in patients with chronic disease: data from Brazil

Authors: Luciane Nascimento Cruz, Marcelo Pio de Almeida Fleck, Carisi Anne Polanczyk

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2010

Login to get access

Abstract

Background

Depressive symptoms are associated with impaired quality of life (QOL). However, there are scarce data comparing the magnitude of depression on QOL among persons with different chronic diseases in developing countries. This study aimed to evaluate the impact of depression on QOL in patients with ischemic heart disease (IHD) and end-stage renal disease (ESRD) in hemodialysis.

Methods

Cross-sectional survey conducted in 173 patients: 103 with IHD and 70 in hemodialysis. Depression was diagnosed by the Mini International Neuropsychiatric Interview-5.0 and depressive symptoms measured by Beck Depression Inventory. QOL was assessed through the Short-Form-36 (SF-36) and World Health Organization Quality of Life Instrument-brief (WHOQOL-brief). Multivariate analyses were performed to assess the association between variables and QOL.

Results

Depression prevalence was 14.3% among IHD patients and 9.9% in the hemodialysis group, and depressive symptoms were present in 39 and 36%, respectively. Regardless of the chronic condition, depressed patients presented lower QOL scores than non-depressed ones in all domains, and the most affected were role emotional, mental health and social functioning of SF-36, and psychological domain of WHOQOL-brief. In linear regression analysis, depressive symptoms were predictive for lower QOL in all domains, with the highest standardized beta coefficients (ranging from −0.26 to −0.64).

Conclusion

Depression is an independent factor associated with worse QOL in IHD and ESRD patients. Among the priorities aiming at improving QOL must be evaluation and management of depressive symptoms.
Literature
1.
go back to reference Aigner M, Förster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M (2006) What does the WHOQOL-Brief measure? Measurement overlap between quality of life and depressive symptomatology in chronic somatoform pain disorder. Soc Psychiatry Psychiatr Epidemiol 41:81–86CrossRefPubMed Aigner M, Förster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M (2006) What does the WHOQOL-Brief measure? Measurement overlap between quality of life and depressive symptomatology in chronic somatoform pain disorder. Soc Psychiatry Psychiatr Epidemiol 41:81–86CrossRefPubMed
2.
go back to reference Amin A, Jones AMH, Nugent K, Rumsfeld JS, Spertus JA (2006) The prevalence of unrecognized depression in patients with acute coronary syndrome. Am Heart J 152:928–934CrossRefPubMed Amin A, Jones AMH, Nugent K, Rumsfeld JS, Spertus JA (2006) The prevalence of unrecognized depression in patients with acute coronary syndrome. Am Heart J 152:928–934CrossRefPubMed
3.
go back to reference Amorim P (2000) Mini International Neuropsychiatric Interview (MINI): validation of a brief interview to diagnose mental disorders. Rev Bras Psiquiatr 22(3):106–115CrossRef Amorim P (2000) Mini International Neuropsychiatric Interview (MINI): validation of a brief interview to diagnose mental disorders. Rev Bras Psiquiatr 22(3):106–115CrossRef
4.
go back to reference Atkinson M, Zibin S, Chuang H (1997) Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiatry 154:99–105PubMed Atkinson M, Zibin S, Chuang H (1997) Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiatry 154:99–105PubMed
5.
go back to reference Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh G (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:53–63 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh G (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:53–63
6.
go back to reference Brown N, Melville M, Gray D, Young T, Munro J, Skene AM, Mampton JR (1999) Quality of life four years after acute myocardial infarction: short-form 36 scores compared with a normal population. Heart 81:352–358PubMed Brown N, Melville M, Gray D, Young T, Munro J, Skene AM, Mampton JR (1999) Quality of life four years after acute myocardial infarction: short-form 36 scores compared with a normal population. Heart 81:352–358PubMed
7.
go back to reference Bush DE, Ziegelstein RC, Tayback M, Richter D, Stevens S, Zahalsky H, Fauerbach JA (2001) Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. Am J Cardiol 88:337–341CrossRefPubMed Bush DE, Ziegelstein RC, Tayback M, Richter D, Stevens S, Zahalsky H, Fauerbach JA (2001) Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. Am J Cardiol 88:337–341CrossRefPubMed
8.
go back to reference Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR (1999) Brazilian–Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Rev Bras Reumatol 39(3):143–150 Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR (1999) Brazilian–Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Rev Bras Reumatol 39(3):143–150
9.
go back to reference DeOreo PB (1997) Hemodialysis patient–assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis 30(2):204–212CrossRefPubMed DeOreo PB (1997) Hemodialysis patient–assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis 30(2):204–212CrossRefPubMed
10.
go back to reference Fayers PM, Hand DJ, Bjordal K, Groenvold M (1997) Causal indicators in quality of life research. Qual Life Res 6:393–406CrossRefPubMed Fayers PM, Hand DJ, Bjordal K, Groenvold M (1997) Causal indicators in quality of life research. Qual Life Res 6:393–406CrossRefPubMed
11.
go back to reference Fleck MPA, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, Pinzon V (2000) Application of the Portuguese version of the abbreviated instrument of quality of life—WHOQOL-brief. Rev Saúde Pública 34(2):178–183CrossRefPubMed Fleck MPA, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, Pinzon V (2000) Application of the Portuguese version of the abbreviated instrument of quality of life—WHOQOL-brief. Rev Saúde Pública 34(2):178–183CrossRefPubMed
12.
go back to reference Furlanetto LM, Mendlowicz MV, Bueno JR (2005) The validity of Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. J Affect Disord 86(1):87–91CrossRefPubMed Furlanetto LM, Mendlowicz MV, Bueno JR (2005) The validity of Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. J Affect Disord 86(1):87–91CrossRefPubMed
13.
go back to reference Gaynes BN, Burns BJ, Tweed DL, Erickson P (2002) Depression and health-related quality of life. J Nerv Ment Dis 190(12):799–806CrossRefPubMed Gaynes BN, Burns BJ, Tweed DL, Erickson P (2002) Depression and health-related quality of life. J Nerv Ment Dis 190(12):799–806CrossRefPubMed
14.
go back to reference Gorenstein C, Andrade L (1996) Validation of a Portuguese version of the beck depression inventory and the state-trait anxiety inventory in Brazilian subjects. Br J Med Biol Res 29:453–457 Gorenstein C, Andrade L (1996) Validation of a Portuguese version of the beck depression inventory and the state-trait anxiety inventory in Brazilian subjects. Br J Med Biol Res 29:453–457
15.
go back to reference Jacobson AM, De Groot M, Samson JA (1997) The effects of psychiatric disorders and symptoms on quality of life in patients with Type I and Type II diabetes mellitus. Qual Life Res 6:11–20CrossRefPubMed Jacobson AM, De Groot M, Samson JA (1997) The effects of psychiatric disorders and symptoms on quality of life in patients with Type I and Type II diabetes mellitus. Qual Life Res 6:11–20CrossRefPubMed
16.
go back to reference Johnson J, Weissman MM, Klerman GL (1992) Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 267(11):1478–1483CrossRefPubMed Johnson J, Weissman MM, Klerman GL (1992) Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 267(11):1478–1483CrossRefPubMed
17.
go back to reference Kimmel PL, Thamer M, Richard C, Ray NF (1998) Psychiatric illness in patients with end-stage renal disease. Am J Med 105:214–221CrossRefPubMed Kimmel PL, Thamer M, Richard C, Ray NF (1998) Psychiatric illness in patients with end-stage renal disease. Am J Med 105:214–221CrossRefPubMed
18.
go back to reference Kimmel PL (2002) Depression in patients with chronic renal disease. What we know and what we need to know. J Psychosom Res 53:951–956CrossRefPubMed Kimmel PL (2002) Depression in patients with chronic renal disease. What we know and what we need to know. J Psychosom Res 53:951–956CrossRefPubMed
19.
20.
go back to reference Lespérance F, Frasure-Smith N (2000) Depression in Patients with cardiac disease: a practical review. J Psychosom Res 48:379–391CrossRefPubMed Lespérance F, Frasure-Smith N (2000) Depression in Patients with cardiac disease: a practical review. J Psychosom Res 48:379–391CrossRefPubMed
21.
go back to reference Lopes AA, Albert JM, Young EW, Stayathum S, Pisoni RL, Andreucci VE, Mapes DL, Mason NA, Fukuhara S, Wikstrom B, Saito A, Port FK (2004) Screening for depression in hemodialysis patients: Associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 66:2047–2053CrossRefPubMed Lopes AA, Albert JM, Young EW, Stayathum S, Pisoni RL, Andreucci VE, Mapes DL, Mason NA, Fukuhara S, Wikstrom B, Saito A, Port FK (2004) Screening for depression in hemodialysis patients: Associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 66:2047–2053CrossRefPubMed
22.
go back to reference Merkus MP, Jeger KJ, Dekker FW, Boeschoten EW, Stevens P, Krediet RT, The Necosad Study Group (1997) Quality of life in patients on chronic dialysis: self assessment 3 months after the start of treatment. Am J Kidney Dis 29(4):584–592CrossRefPubMed Merkus MP, Jeger KJ, Dekker FW, Boeschoten EW, Stevens P, Krediet RT, The Necosad Study Group (1997) Quality of life in patients on chronic dialysis: self assessment 3 months after the start of treatment. Am J Kidney Dis 29(4):584–592CrossRefPubMed
23.
go back to reference Rieckmann N, Kronish IM, Haas D, Gerin W, Chaplin WF, Burg MM, Vorchheimer D, Davidson KW (2006) Persistent depressive symptoms lower aspirin adherence after acute coronary syndromes. Am Heart J 152:922–927CrossRefPubMed Rieckmann N, Kronish IM, Haas D, Gerin W, Chaplin WF, Burg MM, Vorchheimer D, Davidson KW (2006) Persistent depressive symptoms lower aspirin adherence after acute coronary syndromes. Am Heart J 152:922–927CrossRefPubMed
24.
go back to reference Rudisch B, Nemeroff C (2003) Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatry 54:227–240CrossRefPubMed Rudisch B, Nemeroff C (2003) Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatry 54:227–240CrossRefPubMed
25.
go back to reference Rumsfeld JS, Magid DJ, Plomondon ME, O′Brien MM, Spertus JA, Every NR, Sales AE (2001) Predictors of quality of life following acute coronary syndromes. Am J Cardiol 88:781–784CrossRefPubMed Rumsfeld JS, Magid DJ, Plomondon ME, O′Brien MM, Spertus JA, Every NR, Sales AE (2001) Predictors of quality of life following acute coronary syndromes. Am J Cardiol 88:781–784CrossRefPubMed
26.
go back to reference Rumsfeld JS, Magid DJ, Plomondon ME, Sales AE, Grunwald GK, Every NR, Spertus JA (2003) History of depression, angina, and quality of life after acute coronary syndromes. Am Heart J 145:493–499CrossRefPubMed Rumsfeld JS, Magid DJ, Plomondon ME, Sales AE, Grunwald GK, Every NR, Spertus JA (2003) History of depression, angina, and quality of life after acute coronary syndromes. Am Heart J 145:493–499CrossRefPubMed
27.
go back to reference Ruo B, Rumsfeld JS, Hlatky MA, Liu H, Browner ES, Whooley MA (2003) Depressive symptoms and health-related quality of life—the heart and soul study. JAMA 290:215–221CrossRefPubMed Ruo B, Rumsfeld JS, Hlatky MA, Liu H, Browner ES, Whooley MA (2003) Depressive symptoms and health-related quality of life—the heart and soul study. JAMA 290:215–221CrossRefPubMed
28.
go back to reference Sesso R, Rodrigues-Neto JF, Ferraz MB (2003) Impact of socioeconomic status on the quality of life of esrd patients. Am J Kidney Dis 41(1):186–195CrossRefPubMed Sesso R, Rodrigues-Neto JF, Ferraz MB (2003) Impact of socioeconomic status on the quality of life of esrd patients. Am J Kidney Dis 41(1):186–195CrossRefPubMed
29.
go back to reference Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 59 Suppl 20:22–33; quiz 34–57 Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 59 Suppl 20:22–33; quiz 34–57
30.
go back to reference Steele TE, Baltimore D, Finkelstein S, Juergensen P, Kliger AS, Finkelstein FO (1996) Quality of life in peritoneal dialysis patients. J Nerv Ment Dis 184(6):368–374CrossRefPubMed Steele TE, Baltimore D, Finkelstein S, Juergensen P, Kliger AS, Finkelstein FO (1996) Quality of life in peritoneal dialysis patients. J Nerv Ment Dis 184(6):368–374CrossRefPubMed
31.
go back to reference Swenson JR, O’Connor CM, Barton D, Van Zyl LT, Swedberg K, Forman LM, Gaffney M, Glassman AH, Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) Group (2003) Influence of depression and effect of treatment with sertraline on quality of life after hospitalization for acute coronary syndrome. Am J Cardiol 92(11):1271–1276CrossRefPubMed Swenson JR, O’Connor CM, Barton D, Van Zyl LT, Swedberg K, Forman LM, Gaffney M, Glassman AH, Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) Group (2003) Influence of depression and effect of treatment with sertraline on quality of life after hospitalization for acute coronary syndrome. Am J Cardiol 92(11):1271–1276CrossRefPubMed
32.
go back to reference The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-brief quality of life assessment. Psychol Med 28:551–558CrossRef The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-brief quality of life assessment. Psychol Med 28:551–558CrossRef
33.
go back to reference Torres MS, Calderón SM, Díaz IR, Chacón AB, Fernández FL, Martinez IF (2004) Health-related quality of life in coronary heart disease compared to norms in Spanish population. Qual Life Res 13:1401–1407CrossRef Torres MS, Calderón SM, Díaz IR, Chacón AB, Fernández FL, Martinez IF (2004) Health-related quality of life in coronary heart disease compared to norms in Spanish population. Qual Life Res 13:1401–1407CrossRef
34.
go back to reference Valkamo M, Hintikka J, Niskanen L, Koivumaa-Honkanen H, Honkalampi K, Viinamaki H (2001) Depression and associated factors in coronary artery disease. Scand Cardiovasc J 35:259–263CrossRefPubMed Valkamo M, Hintikka J, Niskanen L, Koivumaa-Honkanen H, Honkalampi K, Viinamaki H (2001) Depression and associated factors in coronary artery disease. Scand Cardiovasc J 35:259–263CrossRefPubMed
35.
go back to reference Vázques I, Valderrábano F, Jofré R, Fort J, López-Gomez J, Moreno F, Sanz-Guajardo D (2003) Psychosocial factors and quality of life in young hemodialysis patients with low comorbidity. J Nephrol 16:886–894 Vázques I, Valderrábano F, Jofré R, Fort J, López-Gomez J, Moreno F, Sanz-Guajardo D (2003) Psychosocial factors and quality of life in young hemodialysis patients with low comorbidity. J Nephrol 16:886–894
36.
go back to reference Walters BAJ, Hays RD, Spritzer KL, Fridman M, Carter WB (2002) Health-related quality of life, depressive symptoms, anemia and malnutrition at hemodialysis initiation. Am J Kidney Dis 40(6):1185–1194CrossRefPubMed Walters BAJ, Hays RD, Spritzer KL, Fridman M, Carter WB (2002) Health-related quality of life, depressive symptoms, anemia and malnutrition at hemodialysis initiation. Am J Kidney Dis 40(6):1185–1194CrossRefPubMed
37.
go back to reference Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30(6):473–481CrossRefPubMed Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30(6):473–481CrossRefPubMed
38.
go back to reference Wells KB, Stewart A, Hays RD, Burnam A, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients—results from the medical outcomes study. JAMA 262(7):914–919CrossRefPubMed Wells KB, Stewart A, Hays RD, Burnam A, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients—results from the medical outcomes study. JAMA 262(7):914–919CrossRefPubMed
Metadata
Title
Depression as a determinant of quality of life in patients with chronic disease: data from Brazil
Authors
Luciane Nascimento Cruz
Marcelo Pio de Almeida Fleck
Carisi Anne Polanczyk
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2010
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-009-0141-2

Other articles of this Issue 10/2010

Social Psychiatry and Psychiatric Epidemiology 10/2010 Go to the issue