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Factors associated with life satisfaction in a 6-year follow-up of depressive out-patients

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Abstract

Background

The major goal of mental health services is to improve mental health and thus also life satisfaction. However, studies assessing factors associated with life satisfaction during recovery from depression are lacking.

Methods

A 6-year natural follow-up of 121 depressive out-patients was carried out with questionnaires at baseline, 1/2, 1, 2 and 6 years completed. A structured diagnostic interview was conducted. Throughout the follow-up, clinical status was assessed with several psychometric scales for life satisfaction (LS), depression (BDI, HDRS), hopelessness (HS), functional ability (GAF, SOFAS) and general psychopathology (SCL).

Results

Men and women did not differ in their improvement in life satisfaction. Altogether, 77% of the patients at baseline and 22% at the end were dissatisfied. Life satisfaction on 6-year follow-up was associated with baseline lower interpersonal sensitivity (SCL subscale) and concurrently being loved by someone as well as with baseline and concurrent good self-rated health and wealth. The satisfied were better off in terms of all clinical variables, regardless of the measurement time. Depressive symptoms and hopelessness were the strongest concurrent clinical correlates of LS after 6 years.

Conclusions

Mental health was strongly related to life satisfaction throughout the follow-up, while most of the non-clinical factors were not. Alleviating depression and interpersonal sensitivity and supporting social networks should be focused on in psychiatric treatment in order to improve life satisfaction among depressive patients.

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References

  1. Allardt E (1973) About dimensions of welfare: an explanatory analysis of the comparative Scandinavian survey. Helsinki, Finland: Research Group for Comparative Sociology, University of Helsinki (Research Reports no. 1)

  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC

  3. Andrews FM, Withey SB (1976) Social indicators of well-being. Plenum Press, New York

    Google Scholar 

  4. Appelberg K, Romanov K, Honkasalo M-L, Koskenvuo M (1991) Interpersonal conflicts at work and psychosocial characteristics of employees. Soc Sci Med 32:1051–1056

    Article  PubMed  CAS  Google Scholar 

  5. Bagby RM, Parker JDA, Taylor GJ (1994) The 20-item Toronto Alexithymia Scale-I: Item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32

    Article  PubMed  CAS  Google Scholar 

  6. Bagby RM, Taylor GJ, Parker JDA (1994) The 20-item Toronto Alexithymia Scale-II. Convergent, discriminant, and concurrent validity. J Psychosom Res 38:33–40

    Article  PubMed  CAS  Google Scholar 

  7. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  8. Beck AT, Weissman A, Lester D, Trexler L (1974) The measurement of pessimism: the hopelessness Scale. J Consult Clin Psychol 42:861–865

    Article  PubMed  CAS  Google Scholar 

  9. Bernheim SM, Spertus JA, Reid KJ, Bradley EH, Desai RA, Peterson ED, Rathore SS, Normand SL, Jones PG, Rahimi A, Krumholz HM (2007) Socioeconomic disparities in outcomes after acute myocardial infarction. Am Hearth J 153:313–319

    Article  Google Scholar 

  10. Bray I, Gunnell D (2006) Suicide rates, life satisfaction and happiness as markers for population mental health. Soc Psychiatry Psychiatr Epidemiol 41:333–337

    Article  PubMed  Google Scholar 

  11. Campbell A, Converse PE, Rogers WL (1976) The quality of American life. Russell Sage Foundation, New York

    Google Scholar 

  12. Dear K, Henderson S, Korten A (2002) Well-being in Australia. Findings from the National Survey of mental health and well-being. Soc Psychiatry Psychiatr Epidemiol 37:501–509

    Article  Google Scholar 

  13. Derogatis LR, Lipman RS, Covi L (1973) The SCL-90: an outpatient psychiatric rating scale–preliminary report. Psychopharmacol Bull 9:13–28

    PubMed  CAS  Google Scholar 

  14. Diener E (1994) Assessing subjective well-being: progress and opportunities. Soc Indic Res 31:103–157

    Article  Google Scholar 

  15. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  PubMed  CAS  Google Scholar 

  16. Everson-Rose SA, House JS, Mero RP (2004) Depressive symptoms and mortality risk in a national sample: confounding effects of health status. Psychosom Med 66:823–830

    Article  PubMed  Google Scholar 

  17. Headley B-W, Kelley J, Wearing AJ (1993) Dimensions of mental health: life satisfaction, positive affect, anxiety and depression. Soc Indic Res 29:63–82

    Article  Google Scholar 

  18. Heiskanen T, Niskanen L, Hintikka J, Koivumaa-Honkanen HT, Honkalampi K, Haatainen K, Viinamäki H (2006) Metabolic syndrome and depression: a cross-sectional analyses. J Clin Psychiatry 67:1422–1427

    Article  PubMed  Google Scholar 

  19. Holi MM, Sammallahti PR, Aalberg VA (1998) A Finnish validation study of the SCL-90. Acta Psychiatr Scand 97:42–46

    Article  PubMed  CAS  Google Scholar 

  20. Honkalampi K, Saarinen P, Hintikka J, Virtanen V, Viinamäki H (1999) Factors associated with alexithymia in patients suffering from depression. Psychother Psychosom 68:270–275

    Article  PubMed  CAS  Google Scholar 

  21. Horley J (1984) Life satisfaction, happiness and morale: two problems with the use of subjective well-being indicators. Gerontologist 24:124–127

    PubMed  CAS  Google Scholar 

  22. Joukamaa M, Miettunen J, Kokkonen P, Koskinen M, Julkunen J, Kauhanen J et al (2001) Psychometric properties of the Finnish 20-item Toronto Alexithymia Scale. Nord J Psych 55:123–127

    Article  CAS  Google Scholar 

  23. Jormfeldt H (2010) Attitudes towards health among patients and staff in mental health services: a comparison of ratings of importance of different items on health. Soc Psychiatry Psychiatr Epidemiol 45:225–231

    Article  PubMed  Google Scholar 

  24. Katschnig H, Freeman H, Sartorious N. Quality of life in mental disorders. 2nd edn. Wiley, England

  25. Kaprio J, Sarna S, Koskenvuo M, Rantasalo I (1978) The Finnish twin registry: baseline characteristics, section II: history of symptoms and illnesses, use of drugs, physical characteristics, smoking, alcohol and physical activity. Public Health Publication M 37. Helsinki, University of Helsinki, Department of Public Health

  26. Koivumaa-Honkanen HT (1998) Life satisfaction as a health predictor. Kuopio University Publications D. Medical Sciences 143. Kuopio

  27. Koivumaa-Honkanen H, Honkanen R, Antikainen R, Hintikka J, Laukkanen E, Honkalampi K, Viinamäki H (2001) Self-reported life satisfaction and recovery from depression in a 1-year prospective study. Acta Psychiatr Scand 103:38–44

    Article  PubMed  CAS  Google Scholar 

  28. Koivumaa-Honkanen HT, Honkanen R, Antikainen R, Hintikka J, Viinamäki H (1999) Self-reported life satisfaction and treatment factors in patients with schizophrenia, major depression and anxiety disorder. Acta Psychiatr Scand 99:377–384

    Article  PubMed  CAS  Google Scholar 

  29. Koivumaa-Honkanen H, Honkanen R, Koskenvuo M, Viinamäki H, Kaprio J (2002) Life dissatisfaction as a predictor of fatal injury in a 20-year follow-up. Acta Psychiatr Scand 105:444–450

    Article  PubMed  CAS  Google Scholar 

  30. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2001) Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 158:433–439

    Article  PubMed  CAS  Google Scholar 

  31. Koivumaa-Honkanen H, Honkanen R, Viinamäki, Heikkilä K, Kaprio J, Koskenvuo M (2000) Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. Am J Epidemiol 152:983–991

  32. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2004) Life Satisfaction and depression in a 15-year follow-up of healthy adults. Soc Psychiatry Psyichiatr Epidemiol 39:994–999

    Article  Google Scholar 

  33. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2005) The stability of life satisfaction in a 15-year follow-up of adult Finns healthy at baseline. BMC Psychiatry 5:4

    Article  PubMed  Google Scholar 

  34. Koivumaa-Honkanen H, Koskenvuo M, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J (2004) Life dissatisfaction and subsequent work disability in an 11-year follow-up. Psychol Med 34:221–228

    Article  PubMed  CAS  Google Scholar 

  35. Koivumaa-Honkanen H, Tuovinen TK, Honkalampi K, Antikainen R, Hintikka J, Haatainen K, Viinamäki H (2008) Mental health and well-being in a 6-year follow-up of patients with depression assessed by patients and clinicians. Soc Psychiatry Psychiatric Epidemiol 43(9):688–696

    Article  Google Scholar 

  36. Koivumaa-Honkanen H-T, Viinamäki H, Honkanen R, Tanskanen A, Antikainen R, Niskanen L, Jääskeläinen J, Lehtonen J (1996) Correlates of life satisfaction among psychiatric patients. Acta Psychiatr Scand 94:372–378

    Article  PubMed  CAS  Google Scholar 

  37. Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sörensen TIA (1998) Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits. Int J Obes 22:949–957

    Article  CAS  Google Scholar 

  38. Meyer C, Rumpf H-J, Hapke U, John U (2004) Impact of psychiatric disorders in the general population: satisfaction with life and the influence of comorbidity and disorder duration. Soc Psychiatry Psychiatr Epidemiol 39:435–441

    Article  PubMed  Google Scholar 

  39. Michaud CM, Murray CJ, Bloom BR (2001) Burden of disease—implications for future research. JAMA 285:535–539

    Article  PubMed  CAS  Google Scholar 

  40. Pedersen G, Karterud S (2004) Is SCL-90R helpful for the clinician in assessing DSM-IV symptom disorders? Acta Psychiatr Scand 110:215–224

    Article  PubMed  CAS  Google Scholar 

  41. Ravindran A, Matheson K, Griffiths J, Meralt Z, Anisman H (2002) Stress, coping, uplifts and quality of life in subtypes of depression. A conceptual frame and emerging data. J Affect Disord 71:121–130

    Article  PubMed  Google Scholar 

  42. Romanov K, Appelberg K, Honkasalo M-L, Koskenvuo M (1996) Recent interpersonal conflict at work and psychiatric morbidity: a prospective study of 15, 530 employees aged 24–64. J Psychosom Res 56:328–336

    Google Scholar 

  43. Rutz W (2006) Social psychiatry and public mental health: present situation and future objectives. Time for rethinking and renaissance? Acta Psychiatr Scand Suppl 429:95–100

    Article  PubMed  Google Scholar 

  44. Spitzer RL, Gibbon M, Williams JWB, Endicott J (1966) Global assessment of functioning (GAF) scale. In: Sederer LI, Dickey B (eds) Outcome assessment in clinical practice. Williams and Wilkins, Baltimore

    Google Scholar 

  45. Spitzer RL, Forman JBW, Gibbon M (1987) In: Structured clinical interview for DSM-III-R (SCID). New York State Psychiatric Institute, Biometrics Research, New York

  46. Sung S-C, Yeh M-Y (2007) Factors related to quality of life in depressive outpatients in Taiwan. Psychiatry Clin Neurosci 61:610–615

    Article  PubMed  Google Scholar 

  47. Swami V, Chamarro-Premuzic T, Sinniah D, Maniam T, Kannan K, Stanistreet D, Furham A (2007) General health mediates the relationship between loneliness, life satisfaction and depression. A study with Malaysian medical students. Soc Psychiatry Psychiatr Epidemiol 42:161–166

    Article  PubMed  Google Scholar 

  48. Terraccione A, Löckenhoff CE, Zonderman AB, Ferrucci L, Costa PT (2008) Personality predictors of longevity: Activity, emotional stability, and conscientiousness. Psychosom Med 70:621–627

    Article  Google Scholar 

  49. Trivedi M, Rush J, Wisniewski S, Warden D, McKinney W, Downing M et al (2006) Factors Associated with health-related quality of life among outpatients with major depressive disorder: A STAR*D Report. J Clin Psychiatry 67:185–195

    Article  PubMed  Google Scholar 

  50. Üstün T, Ayuso-Mateos J, Chatterji S et al (2004) Global burden of depressive disorders in the year 2000. Br J Psychiatry 184:386–392

    Article  PubMed  Google Scholar 

  51. Vaillant G (2003) Mental health. Am J Psychiatry 160:1373–1384

    Article  PubMed  Google Scholar 

  52. Viinamäki H, Haatainen K, Honkalampi K, Tanskanen A, Koivumaa-Honkanen H, Antikainen R, Valkonen-Korhonen M, Hintikka J (2006) Which factors are important predictors of non-recovery from major depression? A 2-year prospective observational study. Nord J Psychiatry 60:410–416

    Article  PubMed  Google Scholar 

  53. World Health Organization Constitution (1947) WHO Chronicle 1:29

  54. Zimmerman M, McGlinchey JB, Posternak MA, Friedman M, Attiullah N, Boerescu D (2006) How should remission from depression be defined? The depressed patient’s perspective. Am J Psychiatry 163:148–150

    Article  PubMed  Google Scholar 

  55. Zimmerman M, McGlinchey JB, Posternak MA, Friedman M, Boerescu D, Attiullah N (2008) Remission in depressed outpatients: More than just symptom resolution? J Psych Res 42:797–801

    Article  Google Scholar 

  56. Zimmerman M, Ruggero CJ, Chelminski I, Young D, Posternak MA, Friedman M, Boerescu D, Attiullah N (2006) Developing brief scales for use in clinical practice: the reliability and validity of single-item self-report measures of depression symptom severity, psychosocial impairment due to depression and quality of life. J Clin Psychiatry 67:1536–1541

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Academy of Finland (grant 116996).

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Correspondence to H. Koivumaa-Honkanen.

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Koivumaa-Honkanen, H., Rissanen, T., Hintikka, J. et al. Factors associated with life satisfaction in a 6-year follow-up of depressive out-patients. Soc Psychiatry Psychiatr Epidemiol 46, 595–605 (2011). https://doi.org/10.1007/s00127-010-0225-z

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  • DOI: https://doi.org/10.1007/s00127-010-0225-z

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