Table 3.

Proportions of Patients scoring at ‘Within-Normal’ and ‘Severely-Impaired’ Quality of Life at Entry and Exit from each Level and F/U.

Level*	N	‘Within-Normal QOL’			‘Severely Impaired’ QOL
		Entry (%)	Exit (%)	McNemar Tes p value	Entry (%)	Exit (%)	McNemar Test p value
1	2,280	1.7	29.1	< 0.001	85.6	50.5	< 0.001
2	749	2.9	19.5	< 0.001	83.3	59.5	< 0.001
3	190	1.6	7.9	0.008	89.5	81.1	0.023
4	56	1.8	8.9	0.220	91.1	69.6	0.004
12-m. f/u	414	46.6	31.6	< 0.001	28.5	42.5	< 0.001

P values are considered significant at 0.01 or less (Bonferroni-adjusted).

^*Values compared between entry and exit at each level and between entry to follow-up and exit at 12 months of f/u.

QOL ‘Within-Normal’ is defined as Q-LES-Q scores within 10% of community norms. Since community norm samples have an average Q-LES-Q of 78.3 (SD=11.3), a Q-LES-Q>=70.47 is considered ‘within-normal’ (Endicott et al., 1993, Rapaport et al., 2005, and Schechter et al., 2007). Severe Impairment in QOL is defined as Q-LES-Q scores greater than 2 SD below the community norms. Since community norm samples have an average Q-LES-Q of 78.3 (SD=11.3), a Q-LES-Q=<55.7 is considered ‘severely-impaired’ (Endicott et al., 1993, Rapaport et al., 2005, and Schechter et al., 2007).

STAR*D Levels:

Level 1: Citalopram monotherapy

Level 2: Switching to sertraline, bupropion SR, venlafaxine XR, or CBT OR Augmenting with bupropion SR, buspirone, or CBT

Level 3: Switching to nortriptyline or mirtazapine OR Augmenting with lithium or T3

Level 4: Switching to tranylcypromine OR Switching to venlafaxine XR + mirtazapine

Abbreviations: Q-LES-Q = Quality of Life measure: Quality of Life, Enjoyment, and Satisfaction Questionnaire – Short Form