Association Between Quality Of Life Of Depression Patients After Clinical Cure And The Adverse Drug Reaction Of The Prozac

Background:Depression is a kind of chronic disease with high illness frequence rate and high burden of disease. It has become a common concern public health problem by our country and the world. Quality of life is a kind of brand-new medical assessment technique with full evaluation of the influence of diseases and treatments of diseases on the body, psychological and social factors, in accordance with the new biological -- psychology -- social medical model. The quality of life' level about depression patients is a focus in the field of the treatment of depression. The study found that depression patients'quality of life were influenced on not only the disease but also the drug efficacy and adverse reaction had largely effected the quality of life, because of the long-term medication is needed to control clinical symptoms and to prevent recurrence of clinical symptoms in disease therapeutic process. In recent years, the side effects'influences of antidepressant drugs on the quality of life have appeared to the surface, deserving increasingly more attention. This topic discusses the depression patients' convalescent status of quality of life after clinical cure by taking prozac treatment and the association with the adverse drug reaction of prozac, eliminated the influence of the acute phase depressive symptom on quality of life in patients with depression, and analyzes the influence factors of the drug adverse reaction on the quality of life, for the purpose of improving the quality of life in patients with depression and providing theoretical basis for clinical rational pharmacy. The current domestic studies are lacking in this field.Objectives:1 To explore the depression patients' convalescent status of quality of life after clinical cure by the treatment of taking prozac.2 To probe the association between depression patients' quality of life after the treatment of taking prozac to clinical cure and the adverse drug reaction of the prozac, and analyzes the facors of side effects that influent the quality of life.Methods:Based on the 20% clinical explusion rate and 65% clinical cure rate of prozac for reference,150 Chinese han patients with depression were selected strictly according to the standard as research objects. The age range is from 16 to 65. All comply with the depression diagnosis standard of America mental illness diagnosis and treatment manual (DSM-Ⅳ). We collected generally demographic data, used Hamilton Depression Scale (HAMD17), Hamilton Anxiety Scale (HAMA) to evaluate clinical symptom severity, used the 36-Item Short-Form Health Survey (SF-36) to evaluate the quality of life. The dosage regimen was 20mg-60mg prozac, accompanied by sleep disorders could be given with benzodiazepams. All patients were followed up to evaluate their HAMA, HAMD and TESS score at the 1,2,4,6 and 8 weekend. HAMA and HAMD evaluation scores twice less than seven was up to the standard of clinical cure conditions, the one who up to scratch was asked to evaluate SF-36 and TESS scores again. 11 cases were interrupted by themselves. There was 85 cases of patients up to the clinical cure in 139 patients with complete information, then did the evaluation of SF-36 and the treatment symptoms scale (TESS) again. Within the same time 150 north China health han people aged 16～67 were selected strictly according to the group standard (no mental illness and organic body disease, etc.) as normal control group, through the evaluation about SF-36 to learn their quality of life.Results:1 Generally demographic data analysisThere were no statistically significant difference in distributions of mean age, sex and educational background between depression and normal control groups(P>0.05). The samples were comparable.2 The convalescent status of quality of life of depression patients after treatment1) To compare the non-parameter test analysis of quality of life between patients with depression before treatment and those up to clinical cure conditions after treatment, consequently, the difference was statistically significant in eight areas (PF, RP, BP, GH, VT, SF, RE, MH) of quality of life (P= 0.000).2) To compare the non-parameter test analysis of quality of life between depression patients on clinical cure and normal control group consequently, the difference was statistically significant between two groups in eight areas (PF, RP, BP, GH, VT, SF, RE, MH) of quality of life(P <0.01).3 Association between depression patients'quality of life after clinical cure and the adverse drug reaction of the prozac1) There were 85 cases achieved clinical cure in this example of 139 patients treated by taking prozac. Among them,47 cases appeared the side effects, and 38 cases didn't. To compare the quality of life between the two groups, there were statistically significant differences between them in three fields of role physical (RP) and role emotional (RE) and mental health (MH) (P< 0.05).2) To do correlation analysis on the quality of life of depression patients up to clinical cure and the adverse drug reaction: there were interrelation between the eight dimensions of SF-36 and the four fields of TESS in behavior toxicity, neuro vegetative symptoms, cardiovascular symptoms and other items (P< 0.05).3) To take 11 factors (increased activity, decreased activity, insomnia, sleepiness activities, dry mouth, constipation, sweating, nausea or vomiting, dizziness, headache, anorexia) as independent variable from 47 patients appeared side effects of medication, and to hold eight dimensions of SF-36 scores as dependent variable, with stepwise multiple regression analysis, results showed that decreased activity, dizziness, insomnia, and constipation had influences on seven dimensions (except the body pain) of quality of life in patients with depression at clinical cure period (P< 0.05).Conclusions:1,It is suggested that the symptom of depression persistently damage the quality of life in patients.2,After clinical cure, the level of quality of life of depression patients with side effects was lower than the one that did not appear side effects. It is pointed out the factors of adverse drug reaction influent patients' quality of life.3,Prozac' multiple factors of adverse drug reaction affected of varying degree the quality of life in clinical cure patients. It is suggested that quality of depression patients'life are influented by the side effects of the drug, it deserve should cause our attention.