Determinants of subjective quality of life in depressed patients: The role of self-esteem, response styles, and social support

Kuehner, Christine; Buerger, Christin

doi:10.1016/j.jad.2005.01.014

« Previous Next »Journal of Affective Disorders
Volume 86, Issue 2 , Pages 205-213, June 2005

Determinants of subjective quality of life in depressed patients: The role of self-esteem, response styles, and social support

Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, P.O. Box 122120, 68072 Mannheim, Germany

Received 15 November 2004; received in revised form 19 January 2005; accepted 21 January 2005.

Abstract

Background

We aimed to assess the subjective quality of life (QOL) in depressed patients after discharge from inpatient treatment and to investigate the net impact of self-related constructs (self-esteem, response styles to depressed mood) and of social support on specific subjective QOL domains.

Method

Four weeks after discharge from inpatient treatment, 89 unipolar depressed patients were assessed with a comprehensive battery of psychopathology and psychosocial measures. Subjective QOL was assessed using the World Health Organization Quality of Life Scale (WHOQOL-BREF). Analyses included hierarchical regressions.

Results

Non-remitted patients reported poorer subjective QOL than fully and partially remitted patients regarding physical and psychological health, and overall QOL. After adjusting for demographic and clinical history variables, interviewer-rated severity of depression accounted for 4% to 36% of the variance in individual QOL domain scores. Self-esteem, rumination, distraction and the existence of a partnership added further increments to the explained variance of the psychological QOL domain. Rumination, partnership, and network size of family members providing psychological crisis support also predicted subjective QOL on the social relations domain.

Conclusion

Our results suggest that self-esteem, response styles to depressed mood, and social support characteristics contribute substantially to the psychological and social domains of subjective QOL in depressed patients. These associations are not attributable to concurrent symptom severity. Therapy with depressed patients should not only focus on symptom reduction but should help the patients to establish and maintain supportive relationships and to enhance self-appreciation and skills to cope with negative mood in order to improve psychological well-being and health-related quality of life.

Keywords: Depression, Quality of life, Self-esteem, Response styles, Social support