Ce travail avait pour objectifs d’évaluer la qualité de vie des patients présentant un trouble dépressif caractérisé et d’identifier les facteurs de risque quant à l’origine de cette altération. Cette étude transversale réalisée à la consultation de psychiatrie du CHU de Mahdia durant une période de quatre mois a concerné 360 patients déprimés. Les variables étudiées portaient sur les caractéristiques générales des patients, les caractéristiques cliniques et évolutives du trouble dépressif et les données concernant la prise en charge. L’échelle générique de qualité de vie, la SF-36, (short form) a été utilisée pour l’évaluation. Une standardisation des scores moyens initiaux a été effectuée. Le score moyen global (SMG) à la SF-36 était de 44,6 et 81 % des patients avaient une qualité de vie altérée. La standardisation a révélé une composante mentale particulièrement plus altérée que celle physique. Les régressions logistiques ont permis d’identifier que la survenue d’une altération de la qualité de vie était en rapport avec des paramètres sociodémographiques, cliniques et thérapeutiques. Cette démarche clinimétrique, nous semble permettre de concevoir toute personne souffrant de trouble dépressif dans sa vie entière et non pas seulement sous le seul angle de sa maladie.

Depressive disorders affect many psychosocial and functional aspects, leading to a real social handicap and an alteration in quality of life.

Our purposes were to evaluate the depressive patient’s quality of life and to identify the risk factors responsible for this deterioration.

Our cross sectional study lasted for four months, from 1st March to 30th June 2003, and included 360 depressive patients followed at the psychiatry consultation of the university hospital in Mahdia. The data were collected with a questionnaire composed of 60 items exploring the general characteristics of subjects, the clinical and evolutional characteristics of depressive disorder and providing information on the treatment. Quality of life was measured using the SF-36 (short form) generic scale. A global average score was calculated and it was considered that quality of life was altered if the score was less than 66.7, according to the threshold value of Léan [Arch Intern Med 159 (1999) 837–843]. Moreover, an average score was calculated for each dimension, thus permitting us to identify those most affected. We standardized initial average scores.

The assessment of quality of life revealed a global average score of 44.6 and an alteration in 81% of patients. The study of the dimensional average scores revealed that all dimensions were affected. The standardization also revealed deterioration in all the dimensions, with the mental component particularly more affected than the physical component with respectively estimated scores of 37.3 and 39.1. The analytic approach concerned the relationship between qualitative and quantitative variables and the occurrence of an alteration in quality of life. For this effect, a bivariate study displayed a statistically significant correlation between the eight dimensions of the SF-36 and 20 variables. In order to take into account the relationships which link each variable to the others, and to avoid the bias of the bivariate study, a logistic regression analysis was carried out. Only 12 variables with truly discriminating weight emerged from this analysis. According to the number of dimensions affected, the following factors were classified in decreasing order: the presence of at least two suicide attempts, the association of a psychotropic, the partial or absent observance, the feminine gender, the presence of somatic diseases, the absence of autonomy, the low social-economic level, the presence of a recent hospitalization (<12 months), the age greater than 45 years, the marital status of widow or separated, the number of children under charge greater than five and the presence of severe side effects.

This clinimetric approach permitted us to consider the whole life of each patient suffering from depressive disorder, rather than just the angle of their illness.