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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of a multifaceted secondary prevention intervention in residential homes in the Netherlands were examined, using a quasi-experimental design. In five experimental residential homes, the caregivers received three training sessions on detecting depression and on supporting depressed residents. Furthermore, an information session was organized for all personnel, a further session was organized for residents and their relatives, and several group interventions were offered. 213 residents participated in the study. 211 residents of five other residential homes, matched on basic variables, served as a comparison group. Effects on depressive symptoms (geriatric depression scale) and health related quality of life (MOS-SF-36) were measured at pretest and after the intervention, one year later. Because the drop-out rate was high and drop-outs differed significantly from the remaining population, the scores of drop-outs were imputed. Since we used a quasi-experimental design, we controlled for confounding variables. Regression analyses resulted in significant effects of the intervention on the GDS and on role functioning in the total population. When the analyses were limited to those scoring high on the GDS at pretest, significant effects were found on the GDS, and on four domains of health-related quality of life: psychological distress, role functioning, pain and social functioning. The improvement in GDS scores in GDS cases was significantly larger than in other subjects. Our results suggest that general approaches aimed at a residential home are capable of influencing depressive symptoms in inhabitants. Possibly, it may not be necessary to wait until depressive symptoms have escalated and inhabitants need extensive treatment.
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PMID:Secondary prevention of depressive symptoms in elderly inhabitants of residential homes. 1146 49

Because effects of cigarette smoking on health-related quality of life (HRQL) have not been well described, we carried out a cross-sectional assessment of HRQL using the Medical Outcomes Survey Scale adapted for patients with human immunodeficiency virus (MOS-HIV questionnaire) in 585 HIV-infected homosexual/bisexual men, injection drug users, and female partners enrolled in a multicenter, prospective study of the pulmonary complications of HIV infection. Mean scores for the following dimensions of HRQL were calculated: general health perception, quality of life, physical functioning, bodily pain, social functioning, role functioning, energy, cognitive functioning, and depression. A multivariate model was used to determine the impact on HRQL of the following factors: smoking, CD4 loss, acquired immune deficiency syndrome (AIDS) diagnoses, number of symptoms, study site, education, injection drug use, gender, and age. Current smoking was independently associated with lower scores for general health perception, physical functioning, bodily pain, energy, role functioning, and cognitive functioning (all with p < 0.05). We conclude that patients with HIV infection who smoke have poorer HRQL than nonsmokers. These results support the use of smoking cessation strategies for HIV-infected persons who smoke cigarettes.
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PMID:Adverse impact of cigarette smoking on dimensions of health-related quality of life in persons with HIV infection. 1178 76

Early disability and its rapid progression emphasize the medico-social importance of MS. The widely used disease-modifying treatments allowed to delay the time of severe disability, but this way of treatment is very expensive. The cost of MS is discussed based on literature data. The level of the cost of MS greatly depends on the disease severity and activity. Thus the studies of quality of life (QL) and pharmacoeconomical analysis, besides neurological scales, can give important additional information for clinical trials. First such studies in Europe in patients with secondary progressive MS showed a delay in progression of QL indexes in patients under Betaferon treatment in comparison to placebo. We studied changes in MOS SF-36 and WHO QL scales in groups of 60 MS patients, receiving Rebif or Copaxone. After 3 months of Rebif significant positive changes in scales, reflecting physical and social activity of MS patients, were found. At the same time negative changes in the "Pain" scale might reflect the presence of local side effects of beta-interferons treatment. No statistically significant changes in QL indexes under treatment with Copaxone were seen. The results of QL testing were associated with data of neuropsychological tests, characterizing chronic fatigue and depression. Thus the measurement of QL indexes may be a source of significant additional information, estimating the effecis of treatment and is the basic for pharmacoeconomical analysis.
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PMID:[Quality of life in multiple sclerosis and pharmaco-economic studies]. 1241 97

Symptoms serve as intervention foci for patients and health care providers. Research has established a relationship between symptoms and quality of life for persons living with HIV/AIDS. This article reports symptom prevalence and intensity data that include gynecological and cognitive symptoms self-reported by HIV-infected women (N = 118). Using a cross-sectional, descriptive design, data were obtained using the Center for Epidemiological Studies-Depression Scale (CES-D), Medical Outcomes Study Short Form-36 (MOS SF-36), and the revised Sign and Symptom Check-List for Persons Living with HIV/AIDS (SSC-HIV). Prevalent symptoms were depression (83%), muscle aches (84%), weakness (80%), and painful joints (71%). Symptoms with the highest mean intensity, however, were headaches, rash, insomnia, vaginal itching, and shortness of breath at rest. Symptoms also significantly predicted role functioning. This study contributes to our understanding the nature of symptoms and the influence of symptoms on role and physical functioning among HIV-infected women.
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PMID:The influence of symptoms on quality of life among HIV-infected women. 1498 39

The purpose of this study was to assess the psychometric properties of the Chinese version of the Medical Outcomes Study Social Support Survey (MOS-SSS-C) in a sample of 110 patients. Criterion-related and construct validities of the MOS-SSS-C were evaluated by correlations with the Chinese version of the Multidimensional Perceived Social Support Survey (r =.82) and the Hospital Anxiety and Depression Scale (r = -.58). Confirmatory factor analysis affirmed the four-factor structure of the MOS-SSS-C in measuring the functional aspects of perceived social support. Cronbach's alphas for the subscales ranged from.93 to.96, whereas the alpha for the overall scale was.98. The 2-week test-retest reliability of the MOS-SSS-C as measured by the intraclass correlation coefficient was.84. The MOS-SSS-C is a psychometrically sound multidimensional measure for the evaluation of functional aspects of perceived social support by Chinese patients with chronic disease.
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PMID:Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C). 1504 39

The purpose of this study was to estimate and compare preference scores derived from MOS Short Form-36 (SF-36) data for a sample of lung transplant patients using three methodologies: Fryback et al. (Med Decis Making 1997; 17: 1-9), Nichol et al. (Med Decis Making 2001; 21: 105-112) and Brazier et al. (J Health Econ 2002: 21: 271-292). Data were gathered from 99 lung transplant recipients using a mail survey, which included the SF-36 and other health-related quality of life (HRQL) measures. The mean preference score for the sample was 0.643 (range 0.43-0.83), 0.765 (range 0.36-1.0), and 0.697 (range 0.33-1.00) for Fryback, Nichol and Brazier methods, respectively. Correlations between the derived scores and visual analogue ratings of health (0.58-0.68) and pulmonary symptoms (-0.59 to -0.62) were moderate to good and in the expected directions. The mean preferences of patients grouped by levels of dyspnea, depression symptoms, illness burden, and self-rated general health differed significantly with all methods and supported the construct validity of the derived scores as measures of preference. The Nichol and Brazier scores, both derived with standard gamble utilities, were generally higher than Fryback scores, which are not utility-based. Given the popularity of the SF-36, these three methods could be useful where direct elicitation of preferences is not feasible. Researchers must be cognizant of the derivation method used, as absolute preference levels, hence quality adjusted life years (QALYs), will differ by method.
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PMID:Estimation and comparison of derived preference scores from the SF-36 in lung transplant patients. 1508 10

Although a relatively large body of research has now accumulated concerning the relationship between quality of life (QoL) and nonseasonal depression, there is a dearth of information about QoL in seasonal affective disorder (SAD). The aim of this study was to compare perceived levels of broad ('generic') and health-related QoL in patients with seasonal and nonseasonal depression. Participants were 72 patients with SAD enrolled in an on-going multicentre study in Canada, and 72 patients with nonseasonal major depressive disorder (MDD) matched for severity of depression attending an outpatient psychiatric clinic in Vancouver, British Columbia. All participants completed two measures of QoL (the 20-item Medical Outcomes Study [MOS] Short-Form General Health Survey [SF-20] and the Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) at baseline prior to treatment. The results of the study indicated that both generic and health-related QoL were compromised in patients with SAD compared with general population norms. For example, mean Q-LES-Q scores (range 0-100, where higher scores indicate better QoL) were 44%, compared with scores of 83% reported for the general population. Patients with nonseasonal depression showed significantly poorer functioning in several domains on the SF-20, but no significant differences in Q-LES-Q scores emerged. Perceived QoL is impaired in patients with SAD. Degree of impairment between seasonal and nonseasonal depressives is equivalent when assessed using the Q-LES-Q, but significant inter-group differences are apparent in SF-20 domain scores. Future research is required to determine whether perceived QoL is improved by treatment interventions for seasonal depression such as light therapy or antidepressant medication.
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PMID:Generic and health-related quality of life in patients with seasonal and nonseasonal depression. 1554 81

Amitriptyline, which is a noradrenaline reuptake and 5-HT reuptake inhibitor, has an established role in the management of chronic tension-type headaches. In a single-blind study, patients with chronic tension-type headache were randomized to either fluoxetine 20 mg (a selective 5-HT reuptake inhibitor) or desipramine 75 mg (a selective noradrenaline reuptake inhibitor) and followed for 12 weeks to compare the effectiveness of the two drugs in improving headache, and to assess whether pain control is related to changes in depression. Patients were evaluated at weekly intervals on an analog pain-rating scale and at 4-weekly intervals on the Montgomery and Asberg Depression Rating Scale (MADRS), the MOS general health status questionnaire (SF36), the Hospital Anxiety and Depression Scale (HADS), and a side effects checklist. Eighteen patients were randomized to take fluoxetine and 19 to take desipramine. Of the 25 patients who completed the trial, 12 were on fluoxetine and 13 were on desipramine. There was no significant difference between the two groups at baseline nor in change of pain; reduction in use of analgesic medication; nor change in the HADS, MADRS, or SF36 scores at 12 weeks, but 72% of patients who completed the study improved, and this improvement almost exactly mirrored the improvement on the MADRS. The results from this trial are compatible with the notion that the beneficial effect of antidepressants in chronic tension-type headache is indirect, mediated by an effect on depression, and not more,dependent on serotonin reuptake inhibition than noradrenaline reuptake inhibition.
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PMID:Antidepressant treatment of chronic tension-type headache: a comparison between fluoxetine and desipramine. 1561 68

The assessment of somatoform disorders is complicated by persistent theoretical and practical questions of classification and assessment. Critical rethinking of professional concepts of somatization suggests the value of complementary assessment of patients' illness explanatory models of somatoform and other common mental disorders. We undertook this prospective study to assess medically unexplained somatic symptoms and their patient-perceived causes of illness and to show how patients' explanatory models relate to professional diagnoses of common mental disorders and how they may predict the short-term course of illness. Tertiary care patients (N=186) with prominent somatoform symptoms were evaluated with the Structured Clinical Interview for DSM-IV, a locally adapted Explanatory Model Interview to elicit patients' illness experience (priority symptoms) and perceived causes, and clinical self-report questionnaires. The self-report questionnaires were administered at baseline and after 6 months. Diagnostic overlap between somatoform, depressive, and anxiety disorders occurred frequently (79.6%). Patients explained pure somatoform disorders mainly with organic causal attributions; they explained pure depressive and/or anxiety disorders mainly with psychosocial perceived causes, and patients in the diagnostic overlap group typically reported mixed causal attributions. In this last group, among patients with similar levels of symptom severity, organic perceived causes were related to a lower physical health sum score on the MOS Short Form, and psychosocial perceived causes were related to less severe depressive symptoms, assessed with the Hospital Anxiety and Depression Scale at 6 months. Among patients meeting criteria for comorbid somatoform with anxiety and/or depressive disorders, complementary assessment of patient-perceived causes, a key element of illness explanatory models, was related to levels of functional impairment and short-term prognosis. For such patients, causal attributions may be particularly useful to clarify clinically significant features of common mental disorders and thereby contribute to clinical assessment.
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PMID:Somatization revisited: diagnosis and perceived causes of common mental disorders. 1568 10

Despite increasing interest in the quality of life (QOL) of psychiatric patients in recent years, few studies have focused on the potential adverse effects of the illness on QOL during the period of untreated psychosis. Our study compares the QOL of patients with first-episode schizophrenia when they first presented to the psychiatric service with that of the normal population, and identifies possible relationships with various clinical parameters. One hundred and seventeen patients with schizophrenia (aged 14-28 years) who entered the Early Assessment Services for Young People with Psychosis (EASY) programme in Hong Kong from June 2001 to January 2004 were assessed with the MOS 36 item Short Form Health Survey (SF-36) and the World Health Organization Quality of Life Measure, abbreviated Hong Kong version (WHOQOL-BREF(HK)). We compared their SF-36 scores with controls from the normal population matched by age, sex, marital status and educational level. We assessed clinical parameters including positive, negative and depressive symptoms by the Positive and Negative Syndrome Scale (PANSS), the Scale for Assessment of Negative Symptoms (SANS), and the Montgomery and Asberg Depression Rating Scale (MADRS). When compared with matched controls from the normal population, significantly lower scores in all of the eight scales of the SF-36 were found in our patient group (p < 0.005). Various QOL domain scores had significant inverse correlations with the total MADRS score. However, there was no significant correlation with other clinical parameters. Young patients with first-episode schizophrenia have poorer QOL in the period of untreated psychosis than their counterparts in the community. Amongst various clinical parameters, the severity of depressive symptoms correlates most with QOL.
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PMID:Impact of untreated psychosis on quality of life in patients with first-episode schizophrenia. 1615 68


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