Relationship of Depression, Disability and Quality of Life in Depressive Patients-A Case Control Study

Research Article

J Fam Med. 2015;2(3): 1027.

Relationship of Depression, Disability and Quality of Life in Depressive Patients-A Case Control Study

Jaiswal P, Dalal PK*, Tripathi A, Singh S and Jain S

Department of Psychiatry, King George’s Medical University UP, India

*Corresponding author: Dalal PK, Department of Psychiatry, King George’s Medical University UP, India,

Received: March 18, 2015; Accepted: May 15, 2015; Published: May 18, 2015


Aim: To assess quality of life, disability and burden on spouse of depressed patients.

Methods: The sample size taken for the study is 151 married patients of the depression and similar number of healthy controls. Case group include first two patients registered on specific days aged 18-60 of each week in the adult general psychiatric OPD, King George’s Medical University (K.G.M.U.), Lucknow and for the controls a geographically urban and rural area were identified with the help of NGO (samajdarshan) Lucknow who had close liasoning with the people of the community. The diagnosis was made using DSM-IV-TR criteria. Assessment of quality of life was done by WHO Quality Of Life Scale (WHOQOL), disability with WHO disability assessment schedule (WHODAS) and burden of care with burden assessment schedule (BAS).

Results: In the enrolled cases, 72 (47.68%) patients were male and 79 (52.31%) were female. Among the controls 70 (46.35%) were male and 81 (53.64%) were female. The mean age of cases and controls was 35.93±9.1 and 35.1±9.2 respectively. Depression was analyzed with Hamilton depression scale -21 in the cases and the mean HAM-D-21 score was 17.79±6.10. The domains of QOL was also significantly (P<0.0001) different between cases and controls, representing poor physical health, psychological condition, social relations and poor environmental condition of depressed patients. As per WHO Disability assessment schedule disability was assessed in both cases and controls significantly (P<0.0001) higher disability was observed in depressed patients group. The range is from 12-60. In addition to scales burden on the spouse of depressed patients was assessed and the mean of burden assessment schedule observed was 39.29±4.24.

Conclusion: The findings of this study suggest that quality of life deterioted in patients of depression than controls. There was more disability found in case group than control and significant burden was also seen in spouses of patients of depression.

Keywords: Depression; Disability; Quality of life; Relation; India


Depression is recognized as one of the major health threats in the 21st century. Research suggests that unipolar depression is the most prevalent of all mental disorder. Depression is not only a common, often chronic and recurrent disorder, but it is cardinally associated with significant impairment in work and daily social and psychological well-being [1]. Major depressive disorder (MDD) is the fourth leading cause of disability worldwide [2] and is predicted to become the second leading cause by the year 2020 [3]. The Medical Outcomes Study [4] found that depressed individuals have comparable or worse physical, psychosocial, and role functioning than those who have chronic medical conditions. Similarly, the World Health Organization (WHO) Collaborative Study on Psychological Problems in General Health Care [5] reported increased functional disability, even after controlling for physical disease severity among patients with depression. Furthermore, the longer a patient remains symptomatic, the lower the chances of a complete recovery, [6] and thus greater dysfunction.

Quality of life is defined by the World Health Organization Quality of Life (WHOQOL) Group as individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. This definition reflects the view that quality of life refers to a subjective evaluation that is embedded in a cultural, social and environmental context. The Quality of Life in depression scale is a disease specific patient-reported outcome which assesses the impact that depression has on a patient’s quality of life. Healthrelated quality of life (HRQOL) in depression involves at least 3 specific domains of health—physical, psychological, and social—and each can be measured by either objective assessment or subjective perception. Furthermore, there are many components within each domain (eg, symptoms, ability to function, and disability). Whereas disease-specific instruments focus on the domains most relevant to the disease or condition under study, both generic and diseasespecific instruments of HRQOL have often been used in general populations to assess a wide range of domains applicable to health states, conditions, and diseases [7,8].

Studies comparing and contrasting the relative quality of-life dysfunction for major depressive disorder and anxiety disorders have yielded equivocal findings. Several studies report greater impairment in quality of life for major depressive disorder [9], whereas others report comparable deficits in quality of life for anxiety disorders and major depressive disorder [10]. The proposed study included the quality of life, disability and burden on spouse of depressed patients, the concerning domains of quality of life and its relation with severity of depression. There is extensive review on the family related variables but as cultural difference plays an important role we have thought to throw light on the Indian scenario comparing it with the healthy control.

The extensive and in-depth study will help in the treatment of the patient and formulating psychosocial management programs suitable for the Indian set up. It would also help in directing clinical intervention. Therefore, researches in these fields are required.

Material and Methods


The sample size taken for the study are 151 married patients of the depression and similar number of healthy controls meeting the inclusion exclusion criteria as shown in Figure 1. The procedure used in this study is shown in Figure 2.