Depressive disorder and quality of life in patients with cerebral microangiopathy

• Published in: Sechenovskiĭ vestnik Vol. 11; no. 1; pp. 49 - 58
• Main Authors: Vorob’eva, O. V., Fateeva, V. V.
• Format: Journal Article
• Language: English; Russian
• Published: Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) 23-09-2020
• Subjects: anhedonia; anxiety; cerebral microangiopathy; depression; quality of life
• ISSN: 2218-7332; 2658-3348
• DOI: 10.47093/2218-7332.2020.11.1.49-58

The association between depressive disorder and quality of life of middle-aged patients with cerebral microangiopathy has not been fully investigated.
Aim
. Study the association between the depression level and quality of life (QOL) in patients with cerebral microangiopathy.
Materials and methods
. In outpatients 45–59 years old (n = 262, 42% men, 58% women) with cerebral microangiopathy and depression, the level of anxiety was assessed using the HADS-A scale, QOL — using the SF-36 questionnaire. According to the severity of depression (HADS-D subscale), the following were distinguished: group 1 (n = 116) — 8–10 points (subclinical) and group 2 (n = 146) — ≥11 points (clinical). To analyze the data used: t-test, correlation coefficient, logistic regression model; odds ratio (OR) and 95% confidence interval (CI).
Results
. In group 2, the average anxiety score on the HADS-A scale was 14.3 ± 4.6 points, and for anhedonia was – 10.4 ± 4.2 points, which is statistically significantly higher than in group 1: 10.1 ± 4.2 and 7.1 ± 2.6 points, respectively (p < 0.05). The overall QOL score was statistically significantly lower in group 2: according to the physical component of health, 52.4 ± 26.5 vs. 88.8 ± 43.5 in group 1 (p < 0.05) and psychological component 38.5 ± 19.4 vs. 70.8 ± 35.8 in group 1 (p < 0.05). Depression, anxiety and anhedonia are associated with a negative effect on the overall QOL: r = −0.84 (p < 0.05), r = −0.81 (p < 0.05), r = −0.87 (p < 0.05), respectively. This association does not depend on age, obesity, type 2 diabetes mellitus: OR for depression was 2.1; 95% CI (1.8–2.4), p < 0.05; anxiety — 1.9; 95% CI (1.2–2.2), p < 0.05; anhedonia — 2.3; 95% CI (2.1–2.7), p < 0.05, respectively.
Conclusion
. Clinically significant depression reduces noticeably QOL. An increase in the severity of affective symptoms leads to a deterioration in both the psychological and physical components of QOL. Decreased QOL does not depend on age, obesity, type 2 diabetes mellitus.