Table 4.
Proportions of Remitters/Non-Remitters at ‘Within-Normal and ‘Severely Impaired’ Quality of Life at Entry/Exit from each Level and Follow-up.
| Remitters | Non-Remitters | Difference at Exit |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| Level | N | ‘Within-Normal’ QOL Entry (%) |
‘Within-Normal’ QOL Exit (%) |
McNemar Test p value |
N | ‘Within-Normal’ QOL Entry (%) |
‘Within-Normal’ QOL Exit (%) |
McNemar Test p value |
Chi-Square or Fisher Test p value |
| 1 | 812 | 3.0 | 68.0 | < 0.001 | 1,468 | 1.0 | 7.6 | < 0.001 | < 0.001 |
| 2 | 208 | 5.8 | 52.4 | < 0.001 | 541 | 1.8 | 6.8 | < 0.001 | < 0.001 |
| 3 | 30 | 0 | 40.0 | < 0.001 | 160 | 1.9 | 1.9 | n/a | < 0.001* |
| 4 | 8 | 0 | 25.0 | 0.500 | 48 | 2.1 | 6.3 | 0.630 | 0.144* |
| 12-mo. f/u | 193 | 63.4 | 58.8 | 0.260 | 221 | 31.8 | 7.7 | < 0.001 | < 0.001 |
| Level | N |
‘Severely- Impaired’ QOL Base (%) |
‘Severely- Impaired’ QOL Exit (%) |
McNemar Test p value |
N |
‘Severely-Impaired’ QOL Base (%) |
‘Severely-Impaired’ QOL Exit (%) |
McNemar Test p value |
Chi-Square or Fisher Test p value |
| 1 | 812 | 79.3 | 9.0 | < 0.001 | 1,468 | 89.0 | 73.4 | < 0.001 | < 0.001 |
| 2 | 208 | 74.5 | 16.3 | < 0.001 | 541 | 86.7 | 76.2 | < 0.001 | < 0.001 |
| 3 | 30 | 83.3 | 43.3 | 0.004 | 160 | 90.6 | 88.1 | 0.570 | < 0.001* |
| 4 | 8 | 87.5 | 25 | 0.063 | 48 | 91.7 | 77.1 | 0.065 | 0.007* |
| 12-mo. f/u | 193 | 14.4 | 13.4 | 0.860 | 221 | 40.9 | 68.2 | < 0.001 | < 0.001 |
P values are considered significant at 0.01 or less (Bonferroni-adjusted).
Fisher exact test used due to small sample size
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: f/u = Follow-up; Q-LES-Q = Quality of Life measure: Quality of Life, Enjoyment, and Satisfaction Questionnaire – Short Form