Psychosocial Disability During the Long-term Course of Unipolar Major Depressive Disorder

Judd, Lewis L.; Akiskal, Hagop S.; Zeller, Pamela J.; Paulus, Martin P.; Leon, Andrew C.; Maser, Jack D.; Endicott, Jean; Coryell, William; Kunovac, Jelena; Mueller, Timothy I.; Rice, John P.; Keller, Martin B.

doi:10.1001/archpsyc.57.4.375

Cited by 525 publications

(357 citation statements)

References 26 publications

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“…This distribution of functional impairment among diagnostic groups is highly consistent with the pattern of improvement observed across the groups in our study. The significant relationship between level of symptoms and psychosocial impairment in major depressive disorder observed in our study is consistent with other studies of disability during the course of major depressive disorder (Ormel et al 1993 ;Judd et al 2000).…”

Section: Discussionsupporting

confidence: 93%

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

et al. 2004

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Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable ? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period.

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Section: Discussionsupporting

confidence: 93%

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

et al. 2004

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“…Impairments in social functioning in depression contribute strongly to the increased burden of depression (Greenberg et al 2003;Eaton et al 2008) and predict depressive relapse and recurrences (e.g. Leon et al 1999;Judd et al 2000;Solomon et al 2004;Vittengl et al 2009). Impairments in social functioning in depression are also related to high economic costs.…”

Section: Introductionmentioning

confidence: 99%

The effect of psychotherapy for depression on improvements in social functioning: a meta-analysis

Renner

Cuijpers²,

Huibers

2014

Psychol. Med.

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Background. Patients with depression often report impairments in social functioning. From a patient perspective, improvements in social functioning might be an important outcome in psychotherapy for depression. Therefore, it is important to examine the effects of psychotherapy on social functioning in patients with depression.Method. We conducted a meta-analysis on studies of psychotherapy for depression that reported results for social functioning at post-treatment. Only studies that compared psychotherapy to a control condition were included (31 studies with 2956 patients).Results. The effect size of psychotherapy on social functioning was small to moderate, before [Hedges' g = 0.46, 95% confidence interval (CI) 0.32-0.60] and after adjusting for publication bias (g = 0.40, 95% CI 0.25-0.55). Univariate moderator analyses revealed that studies using care as usual as a control group versus other control groups yielded lower effect sizes, whereas studies conducted in the USA versus other countries and studies that used clinician-rated instruments versus self-report yielded higher effect sizes. Higher quality studies yielded lower effect sizes whereas the number of treatment sessions and the effect size of depressive symptoms were positively related to the effect size of social functioning. When controlling for these and additional characteristics simultaneously in multivariate meta-regression, the effect size of depressive symptoms, treatment format and number of sessions were significant predictors. The effect size of social functioning remained marginally significant, indicating that improvements in social functioning are not fully explained by improvements in depressive symptoms.Conclusions. Psychotherapy for depression results in small to moderate improvements in social functioning. These improvements are strongly associated with, but not fully explained by, improvements in depressive symptoms.

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“…Following each new episode, the condition of depression becomes worse and risk of next relapse increases [7,8]. Researchers found that risk of relapse after experiencing one episode of major depression was 50%, after two was 80% and after three might be up to 90% [9,10].These relapses are associated with considerable high cost to individual, family, and society [6,11]. Therefore, in view of the nature of depressionrelated impairments and future implication of recurrent depression, attempting to prevent the relapse of depression is an important clinical therapeutic goal for longterm management of MDD.…”

Section: Introductionmentioning

confidence: 99%

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

Miranda

Green

Krupnick

et al. 2006

Journal of Consulting and Clinical Psychology

112

102

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Background: The risk of relapse in major depressive disorder (MDD) is associated with high worldwide disease burden. Cognitive behavioral therapy (CBT) and its modifications might be effective in relapse prevention. The aim of this review was to evaluate the efficacy of these treatments for reducing relapse of MDD. Methods: The retrieval was performed in the databases of MEDLINE via Pubmed, EMBASE and PsycINFO via OVID, The Cochrane Library and four Chinese databases. Clinical trials registry platforms and references of relevant articles were retrieved as well. Hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to pool evidences. Results: A total of 16 eligible trials involving 1945 participants were included. In the first 12 months, CBT was more efficacious than control in reducing the risk of developing a new episode of depression for MDD patients in remission (HR:0.50, 95%CI:0.35-0.72, I 2 = 11%). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR:0.46, 95%CI:0.31-0.70, I 2 = 38%). Besides, compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR:0.76, 95%CI:0.58-0.98, I 2 = 0%). These positive effects might be only maintained at two and nearly 6 years follow up for CBT. Conclusion: The use of CBT for MDD patients in remission might reduce risk of relapse. Besides, the effect of MBCT was moderated by number of prior episodes and MBCT might only be effective for MDD patients with 3 or more previous episodes. Further exploration for the influence of previous psychological intervention is required.

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Psychosocial Disability During the Long-term Course of Unipolar Major Depressive Disorder

Abstract: Background: The goal of this study was to investigate psychosocial disability in relation to depressive symptom severity during the long-term course of unipolar major depressive disorder (MDD).

Cited by 525 publications

References 26 publications

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

The effect of psychotherapy for depression on improvements in social functioning: a meta-analysis

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

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