Health-related quality of life in patients with depression treated with duloxetine or a selective serotonin reuptake inhibitor in a naturalistic outpatient setting

Figures & data

Table 1 Baseline patient characteristics by treatment cohorts

Baseline characteristic	Duloxetine (n=556)	SSRI (n=776)	P-value
Age, mean (SD), years	38.2 (10.2)	37.9 (10.7)	0.539
Female, %	51.8	59.8	0.004
Region, %			<0.001
Mexico	29.1	51.5
East Asia	41.4	29.0
The Middle East	27.3	15.9
Others	2.2	3.6
Age at first symptoms of MDD, mean (SD), years	34.3 (10.6)	33.3 (11.6)	0.078
BMI (kg/m^2), mean (SD)	24.6 (4.4)	24.8 (4.3)	0.277
Living with a spouse/partner, %	69.9	69.7	0.948
Independent living (living in his/her own apartment or house), %	12.4	19.3	<0.001
Educational attainment, %			0.020
≤ Primary school	6.3	9.7
Secondary school/occupational program	42.3	45.2
≥ University	51.4	45.1
Employment status, %			0.057
Full time	57.0	54.5
Economically inactive	22.8	28.4
Unemployed/part-time	20.1	17.1
CGI-S, mean (SD)	4.5 (0.7)	4.6 (0.7)	0.292
QIDS-SR16, mean (SD)	14.2 (4.6)	14.5 (5.0)	0.356
SSI-pain, mean (SD)	15.2 (5.1)	13.8 (5.0)	<0.001
Had MDD episodes in the past 24 months, %	66.2	65.3	0.747
Number of comorbidities, %			0.177
0	77.0	72.5
1	17.5	21.2
2+	5.4	6.2
Any treatments/therapies for depression in the past 24 months, %	42.6	44.2	0.568
Painful physical symptoms, %	58.5	46.5	<0.001

Abbreviations: BMI, body mass index; CGI-S, Clinical Global Impressions of Severity; MDD, major depressive disorder; QIDS-SR₁₆, 16-item Quick Inventory of Depressive Symptomatology Self-Report; SD, standard deviation; SSI-pain, somatic symptom inventory; SSRI, selective serotonin reuptake inhibitor.

Table 2 Mean levels (raw values) of QoL at baseline and at 24 weeks by treatment cohorts with and without PPS at baseline

Outcome	Total			PPS+			PPS−
	Duloxetine	SSRI	Effect sizesa	Duloxetine	SSRI	Effect sizesa	Duloxetine	SSRI	Effect sizesa
EQ-5D
At baseline	0.46 (0.32)	0.47 (0.33)	−0.03	0.37 (0.33)	0.40 (0.34)	−0.09	0.58 (0.26)	0.54 (0.31)	0.14
At week 24	0.95 (0.11)b	0.90 (0.16)	0.35	0.95 (0.10)b	0.86 (0.19)	0.59	0.95 (0.12)b	0.92 (0.12)	0.25
EQ-VAS
At baseline	43.39 (24.36)	42.99 (26.94)	0.02	40.77 (24.23)	39.48 (27.25)	0.05	47.07 (24.11)	46.02 (26.36)	0.04
At week 24	75.64 (34.02)b	69.02 (32.79)	0.20	74.88 (34.94)b	66.88 (33.28)	0.23	76.75 (32.69)b	70.62 (32.38)	0.19

Notes:

a These show effect sizes of QoL differences between treatment cohorts.

b P<0.05 for all comparisons of outcomes between the duloxetine cohort and the SSRI cohort in the overall sample, PPS+ patients, and PPS- patients, respectively.

Abbreviations: EQ-VAS, EuroQoL-Visual Analog Scale; EQ-5D, EuroQoL-5 Dimensions; PPS, painful physical symptoms; QoL, quality of life; SSRI, selective serotonin reuptake inhibitor.

Figure 1 The estimated mean levels of QoL during follow-up by treatment cohorts.

Notes: (A) EQ-5D scores by treatment cohorts. (B) EQ-VAS scores by treatment cohorts. P<0.05 for all comparisons between the duloxetine cohort and the SSRI cohort at each postbaseline visit. ^aThe baseline scores are raw mean values.
Abbreviations: SSRI, selective serotonin reuptake inhibitor; QoL, quality of life; EQ-5D, EuroQoL-5 Dimensions; EQ-VAS, EuroQoL-Visual Analog Scale.

Figure 2 The estimated mean levels of QoL during follow-up by treatment cohorts in patients with and without PPS at baseline.

Notes: (A) EQ-5D scores by treatment cohorts. (B) EQ-VAS scores by treatment cohorts. P<0.05 for all comparisons between the duloxetine cohort and the SSRI cohort at 24 weeks in both PPS+ and PPS− patients, respectively. ^aThe baseline scores are raw mean values.
Abbreviations: PPS, painful physical symptoms; SSRI, selective serotonin reuptake inhibitor; QoL, quality of life; EQ-5D, EuroQoL-5 Dimensions; EQ-VAS, EuroQoL-Visual Analog Scale.

Table 3 The results of MMRM analyses: factors associated with EQ-5D scores during follow-up

Parameter	Parameter estimate	Standard error	P-value
Intercept	0.850	0.030	<0.001
Age	−0.001	0.000	0.095
Female (versus male)	−0.022	0.008	0.009
Region (versus East Asia)
Mexico	0.025	0.010	0.009
The Middle East	−0.028	0.012	0.019
Others	−0.038	0.026	0.140
Employment (versus full time)
Economically inactive	−0.019	0.009	0.048
Unemployed/part-time	−0.013	0.011	0.236
Not living in his/her own house	0.023	0.010	0.029
EQ-5D index at baseline	0.087	0.015	<0.001
QIDS-SR16 score at baseline	−0.002	0.001	0.107
SSI-pain score at baseline	−0.004	0.001	<0.001
Comorbidities (versus none)
1	−0.034	0.010	0.001
2+	−0.113	0.018	<0.001
Had MDD episodes in the 24 months prior to baseline	−0.021	0.008	0.008
Duloxetine (versus SSRI)	0.034	0.011	0.002
Weeks (versus week 8)
Week 16	0.072	0.007	<0.001
Week 24	0.117	0.008	<0.001
Weeks × treat
Duloxetine at week 16	0.027	0.011	0.012
Duloxetine at week 24	0.035	0.012	0.003

Abbreviations: EQ-5D, EuroQoL-5 Dimensions; QIDS-SR₁₆, 16-item Quick Inventory of Depressive Symptomatology Self-Report; SSRI, selective serotonin reuptake inhibitor; MMRM, mixed effects modeling with repeated measures; MDD, major depressive disorder; SSI-pain, somatic symptom inventory; QoL, quality of life.

Table 4 The results of MMRM analyses: factors associated with EQ-VAS scores during follow-up

Parameter	Parameter estimate	Standard error	P-value
Intercept	18.371	5.498	0.001
Age	−0.164	0.061	0.007
Female (versus male)	−1.022	1.302	0.433
Region (versus East Asia)
Mexico	−5.353	1.539	0.001
The Middle East	−16.048	1.813	<0.001
Others	−8.566	4.161	0.040
CGI-S score at baseline	4.190	0.954	<0.001
EQ-VAS score at baseline	0.733	0.025	<0.001
SSI-pain score at baseline	0.237	0.129	0.068
Comorbidities (versus none)
1	−4.181	1.680	0.013
2+	−5.546	2.981	0.063
Had MDD episodes in the 24 months prior to baseline	−1.071	1.328	0.420
Duloxetine (versus SSRI)	3.953	1.322	0.003
Weeks (versus week 8)
Week 16	6.741	0.586	<0.001
Week 24	10.656	0.719	<0.001
Weeks × treat
Duloxetine at week 16	1.456	0.901	0.106
Duloxetine at week 24	2.793	1.106	0.012

Abbreviations: EQ-VAS, EuroQoL-Visual Analog Scale; CGI-S, Clinical Global Impressions of Severity; SSRI, selective serotonin reuptake inhibitor; MMRM, mixed effects modeling with repeated measures; MDD, major depressive disorder; SSI-pain, somatic symptom inventory; QoL, quality of life.