Health-Related Quality of Life in Male Patients under Treatment for Substance Use Disorders with and without Major Depressive Disorder: Influence in Clinical Course at One-Year Follow-Up

Abstract

Health-related quality of life (HRQoL) assessment has interest as an indicator of degree of affectation and prognosis in mental disorders. HRQoL is impaired in both Substance Use Disorder (SUD) and Major Depressive Disorder (MDD), two conditions highly prevalent, although less studied when both are coexisting (SUD + MDD). Hence, we decided to explore HRQoL with the SF-36 survey in a sample of 123 SUD and 114 SUD + MDD patients (51 symptomatic and 63 asymptomatic of depressive symptoms) under treatment. We performed analyses to examine HRQoL among groups, and its predictive value at 3-, 6- and 12-month follow-ups through regression models. Patients with SUD + MDD had worse HRQoL than SUD patients and population norms. For Mental Health, Vitality, and General Health dimensions, lower scores were observed for SUD + MDD regardless the presence/absence of depressive symptoms. For Physical Functioning and Health Change, depressive symptomatology and not the comorbidity of SUD + MDD diagnoses explained HRQoL limitations. At 3-, 6- and 12-month follow-ups we observed two predictors of relapses, General Health for asymptomatic SUD + MDD, and Physical Functioning for SUD. Improving HRQoL in SUD + MDD may be targeted during patient’s treatment; future studies should explore the influence of HRQoL on patient’s prognosis taking into account the presence/absence of depressive symptomatology.

Circadian Functioning and Quality of Life in Substance Use Disorder Patients With and Without Comorbid Major Depressive Disorder

“…Regarding the sociodemographic characteristics of the patients, in contrast with other studies, no differences were observed in marital (26,30), employment, and socioeconomic status between groups (28), but a lower educational level in the SUD + MDD group (38,39) was reported compared with the SUD ones. The reasons that can differentiate these results are the type of gender population as well as the conducted geographical areas and the age of SUD onset.…”

“…Consistent with previous findings, we did not find any differences between groups in the age of SUD onset between groups (30). The SUD + MDD patients showed higher rates of medical disorder comorbidity (30,37,59) and more suicide attempts (26,28,30,32,37,59,60).…”

“…From another point of view, cultural differences in each society, such as differences in financial and social levels and personality traits, can lead to different results in sociodemographic variables. Regarding more law and legal problems observed in the SUD group, these can be related to greater impulsivity (13,58), lower disability pension, and lack of economic income (30).…”

“…The term dual disorder refers to the coexistence or concurrence of at least one SUD and another mental disorder in the same person (23,24). Dual disorder patients suffer higher rates of psychiatric hospitalizations (25), suicide attempts (26), more social problems and delinquent behaviors (24,27), worse QOL (28)(29)(30), lower social consultation, and lesser use of social support (31), compared with those without comorbidity. A great body of research has indicated that substance use can exacerbate depression (27,32,33).…”

Special Issue: Diagnosis and Management of Addiction and Other Mental Disorders (Dual Disorders)

“…Three contributions from this special issue have focused on the study of this comorbidity, which we will refer to as dual depression. The research by Marquez-Arrico et al [ 7 ] found that various dimensions of a health-related quality of life in patients with dual depression are worse than those with only SUD although the presence of depressive symptoms and not DD explains the differences observed in physical functioning and health change. In addition, the quality of life shows the predictive capacity of a relapse at a one-year follow-up differential according to the diagnosis.…”