Health-Related Quality-of-Life Measure Enhances Acute Treatment Response Prediction in Depressed Inpatients

Background: Many nonbiological variables arereported to predict treatment response for major depression;however, there is little agreement about which variables are mostpredictive.

Method: Inpatient subjects (N = 59) diagnosedwith current DSM-IV major depressive disorder completed weeklydepressive symptom ratings with the Hamilton Rating Scale forDepression (HAM-D-17) and Beck Depression Inventory (BDI), andweekly health-related quality-of-life (HRQL) ratings with theQuality of Well-Being Scale (QWB). Acute responders wereidentified by a 50% decrease in HAM-D-17 score from baselinewithin 4 weeks of medication treatment. Predictor variables wereinitially chosen from a literature review and then tested fortheir association with acute treatment response.

Results: An initial predictive modelincluding age at first depression, admission BDI score, andmelancholia predicted acute treatment response with 69% accuracyand was designated as the benchmark model. Adding the admissionQWB index score to the benchmark model did not improve theprediction rate; however, adding the admission QWB subscales forphysical and social activity to the benchmark model significantlyimproved acute treatment response prediction to 86% accuracy (p =.001).

Conclusion: In addition to being designed foruse in cost-effectiveness analyses, the QWB subscales appear tobe useful HRQL variables for predicting acute inpatientdepression treatment response.