Functional Impairment and Quality of Life of patients with Major Depressive Disorder in Euthymia

Abstract

Background: Symptomatic remission has long been the goal of treatment in Major Depressive Disorder. Remission from depression is accompanied by improvements in functioning. Residual symptoms in remission affect their ability to function at work, home, social settings and worsen their quality of life. Objectives: To assess the level of Functional Impairment and Quality of Life of Major Depressive disorder patients in the euthymic state, determine the association between degree of functional impairment with socio demographic variables and clinical parameters and to compare the functional impairment and quality of life at initial assessment and follow up assessment at three and six months. Patients and methods: Cross sectional study of one year duration was done in outpatient setting comprising of subjects on treatment for Major Depressive disorder in euthymia (Hamilton depression rating scale score<7). Sociodemographic, clinical data were obtained, functional impairment was measured using Indian Disability Evaluation Assessment Scale and quality of life assessed with WHO-QOL-BREF questionnaire at initial, three and six month follow up. Statistical analysis was done. Results: 221 subjects were followed up and 19 relapsed and 10 were lost to follow up. Mean IDEAS score was 4.69 and SD 1.67, work and interpersonal activities domain was most affected and mean QOL was 56.67 and SD 4.913 at initial assessment. Age, education and marital status of subjects had significant association with IDEAS score. Duration of illness, number of episodes had a positive correlation and QOL scores had negative correlation with IDEAS score. IDEAS score reduced by an average of 0.401 and QOL scores increased by an average of 4.224 at six months. Conclusion: Measures of functional impairment provide insight into the total impact of Major Depressive Disorder. Symptomatic remission does not necessarily imply functional recovery. Complete clinical and functional recovery should be the aim of treatment.