Loss of interest, depressed mood and impact on the quality of life: Cross-sectional survey
1 Department of Psychiatry, Institute of Psychiatry of Clinics Hospital Faculty of Medicine University of Sao Paulo, (Rua Dr. Ovídio Pires de Campos, 785 - 3° andar - sala 13), Sao Paulo, (CEP: 05403-010), Brazil
2 Division of Psychology, Central Institute of Clinics Hospital Faculty of Medicine University of Sao Paulo, (Rua Dr. Ovídio Pires de Campos, 225. PAMB Térreo), Sao Paulo, (CEP: 05403-000), Brazil
3 Department of Preventive Medicine, Faculty of Medicine University of Sao Paulo, (Av. Dr. Arnaldo, 455 - 2° andar), Sao Paulo, (CEP: 01246-903), Brazil
4 Department of Clinical Medical, Faculty of Medicine University of Sao Paulo, (Av. Dr. Arnaldo, 455 - 1° andar - sala 1216), Sao Paulo, (CEP: 01246-903), Brazil
5 Department of Clinical Psychology, Institute of Psychology of University of Sao Paulo, (Av. Professor Mello Moraes, 1721 - Bloco F - Cidade Universitária), Sao Paulo, (CEP: 05508-030), Brazil
BMC Public Health 2011, 11:826 doi:10.1186/1471-2458-11-826Published: 25 October 2011
Depressive symptoms and chronic disease have adverse effects on patients' health-related quality of life (H-RQOL). However, little is known about this effect on H-RQOL when only the two core depressive symptoms - loss of interest and depressed mood - are considered. The objective of this study is to investigate H-RQOL in the presence of loss of interest and depressed mood at a general medical outpatient unit.
We evaluated 553 patients at their first attendance at a general medical outpatient unit of a teaching hospital. H-RQOL was assessed with the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Depressed mood and loss of interest were assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD)-Patient Questionnaire. A physician performed the diagnosis of chronic diseases by clinical judgment and classified them in 13 possible pre-defined categories. We used multiple linear regression to investigate associations between each domain of H-RQOL and our two core depression symptoms. The presence of chronic diseases and demographic variables were included in the models as covariates.
Among the 553 patients, 70.5% were women with a mean age of 41.0 years (range 18-85, SD ± 15.4). Loss of interest was reported by 54.6%, and depressed mood by 59.7% of the patients. At least one chronic disease was diagnosed in 59.5% of patients; cardiovascular disease was the most prevalent, affecting 20.6% of our patients. Loss of interest and depressed mood was significantly associated with decreased scores in all domains of H-RQOL after adjustment for possible confounders. The presence of any chronic disease was associated with a decrease in the domain of vitality. The analysis of each individual chronic disease category revealed that no category was associated with a decrease in more than one domain of H-RQOL.
Loss of interest and depressed mood were associated with significant decreases in H-RQOL. We recommend these simple tests for screening in general practice.