Health Related Quality of Life among Patients with Chronic Medical Diseases and Comorbid Depression Related Quality Of Life among Patients with Chronic Medical Diseases and Comorbid Depression

Abstract

Background: Health related quality of life has been affected to a greater extent by chronic medical conditions, neurological and psychiatric illnesses. Medical conditions comorbid with psychiatric illnesses have increased negative effect on the health related quality of life of the affected individuals. However, there is a dearth of data in Ethiopia in this aspect. Therefore, the current study assessed the health related quality of life among patients with chronic medical diseases and  comorbid depression.

Method: An institutional based cross-sectional study was conducted from May1-June 30/2020 among 377 patients with chronic medical conditions comorbid with depression. Consecutive sampling technique was used to select study participants. World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to measure the health related quality of life (HRQOL). Depression was assessed using patient health questionnaire (PHQ-9) whereas perceived stigma was measured using the perceived devaluation and discrimination scale (PDD). The Oslo social support scale (OSSS-3) was used to measure the level of social support. The diagnoses of patients’ chronic medical conditions were extracted from medical charts.  Multiple Linear Regression analysis with P-value 0.05 was used to measure the statistically significant association between Quality of life and independent variables.

Result: Out of the 4 domains, the psychological domain of Health related quality of life (HRQOL) had the lowest mean score 39.73±13.44 and the social domain of HRQOL had the highest score 50.13±18.77. Socio-demographic factors including single and divorced marital status, private employed, merchant, farmer and house wife in occupation, unable to read and write, able to read and write and primary school in educational status were significantly associated with one or more of the HRQOL domains. Diagnosis of epilepsy, history of admission, frequency of follow up treatments, history of medication discontinuation, and personal history of mental illness, depression score, perceived stigma score, moderate social support and history of suicidal ideation were the clinical factors significantly associated with various domains of HRQOL.

Conclusion: The mean score of HRQOL domains among chronic medical patients comorbid with depression was low. This could be due to the chronic medical condition and depression had negatively affected quality of life. Every two month treatment follow up frequency, PHQ-9 and stigma score were statistically significant to the four domains of quality of life. Thus, using integrative medical and psychosocial intervention approach emphasizing on factors affecting HRQOL is paramount importance for better outcome.