Depressive disorder and quality of life in patients with cerebral microangiopathy

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.