Background: Prior investigations have demonstrated a link between quality o
f life (QOL) deficits and depression. This report elaborates on prior inves
tigations findings by implementation of formal assignment of the diagnosis
of depression and a hierarchical approach to assessment of QOL. Methods: A
masters or doctoral level mental health clinician used the SCID to confirm
a diagnosis of major depression in ninety psychiatric inpatients. Function
was assessed with the PSMS (a measure of ADL), the IADL scale, and the "dai
ly living and role functioning" and the "relation to self and others" subsc
ales of the Basis-32. Results: Patient age and severity of depression were
the most consistent predictors of QOL deficits, although the direction of t
he age-effect on QOL depended on the specific measure of QOL. Increasing se
verity of depression was consistently associated with worse QOL, and remain
ed significant after adjusting for age. Limitations: The cross-sectional me
thod of this study limits the inference of causality between depression sev
erity and poor QOL. Conclusions: QOL deficits in acutely depressed hospital
ized patients occur at multiple strata in the hierarchy of behavior and are
most consistently influenced by age and severity of depression. The effect
of age on QOL in depressed inpatients is complex, and age is not uniformly
associated with poor QOL, (C) 1999 Elsevier Science B.V. All rights reserv
ed.