The concept of recovery in major depression

Fava, Giovanni A.; Ruini, Chiara; Belaise, Carlotta

doi:10.1017/s0033291706008981

Cited by 203 publications

(159 citation statements)

References 96 publications

(127 reference statements)

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“…A recuperação não pode ser entendida, somente, pelos índices de remissão ou resposta a um determinado tratamento. Mediante esses itens não é possível aferir o impacto da presença de sintomas residuais, a qualidade desses sintomas ou de outros fatores envolvidos nesse processo (como a capacidade de retornar para as atividades sociais ou profissionais) 61,62 . Portanto, apesar das dificuldades citadas acima, a avaliação da qualidade de vida é uma medida relevante para a avaliação de sujeitos com depressão.…”

Section: Aplicabilidade E Limitações Metodológicas Na Avaliação Da Asunclassified

Qualidade de vida e depressão: uma revisão da literatura

Lima¹,

Fleck

2009

Rev. psiquiatr. Rio Gd. Sul

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Endereço para correspondência RESUMOOs sintomas depressivos são altamente prevalentes, principalmente em serviços de cuidados primários, provocando sérios prejuízos nos sujeitos que não são submetidos a tratamento. O objetivo deste estudo foi o de revisar o impacto da associação entre depressão maior e qualidade de vida. Foram revisados os artigos publicados entre 1990 e 2007, utilizando as palavras-chave "qualidade de vida", "depressão", "sintomas depressivos", "serviços de cuidados primários", "bem-estar e felicidade" e "preditores de remissão". A presença de sintomas depressivos afeta todas as dimensões da qualidade de vida e, conforme a gravidade desses sintomas, o seu impacto na qualidade de vida pode ser maior do que o de outras doenças crônicas. Os resultados sugerem que a presença de sintomas depressivos exerce um importante impacto na qualidade de vida dos sujeitos, não se restringindo apenas às características clínicas do transtorno. Entretanto, ainda existe uma carência de modelos teóricos, assim como de estudos longitudinais, que possam estabelecer de forma mais clara qual é a real relação entre depressão e qualidade de vida. Provavelmente, através do entendimento de medidas subjetivas e objetivas de recuperação dos sujeitos com sintomas depressivos, poderão se buscar intervenções mais eficazes e que provoquem melhorias no funcionamento global dessa população. Sendo assim, a avaliação da qualidade de vida aparece como um desfecho relevante, pois pela sua multidimensionalidade é potencialmente capaz de detectar a magnitude e a abrangência do comprometimento que a depressão impõe.Descritores: Qualidade de vida, depressão, serviço de cuidados primários, preditores de remissão, bem-estar, felicidade. ABSTRACTDepressive symptoms are highly prevalent, mainly in primary health care services, causing serious impairments in those subjects that are not treated. The objective of this study was to review the impact of the association between depressive disorder and quality of life. Our review included articles published between 1990 and 2007 and it was based on the following keywords: quality of life, depression, depressive symptoms, primary care services, well-being, happiness, and predictors of remission. The presence of depressive symptoms affects all dimensions of the quality of life, and depending on the severity of these symptoms, it might cause equivalent or more severe impairment than other chronic diseases. The findings suggest that the presence of depressive symptoms causes a serious impact on the quality of life of individuals. Such impact is not limited to the clinical characteristics of the disorder. However, there is still a lack of theoretical models and longitudinal

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Section: Aplicabilidade E Limitações Metodológicas Na Avaliação Da Asunclassified

Qualidade de vida e depressão: uma revisão da literatura

Lima¹,

Fleck

2009

Rev. psiquiatr. Rio Gd. Sul

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“…However, there is comorbidity which wanes upon successful treatment of depression and comorbidity which persists, in syndromic or subsyndromic forms (residual symptoms) [2]. Clinical differentiation of such morbidity requires a shift from the current psychometric model (where severity is determined by the number of symptoms and not by intensity or quality) to a clinimetric model [14,15,16], which may allow to define the progression, extent and severity of depressive illness.…”

Section: The Inadequacies Of Standard Clinical Assessmentmentioning

confidence: 99%

“…In a survey on factors identified by depressed outpatients as important in determining remission, the most frequently judged as such were the presence of features of positive mental health, such as optimism and self-confidence [47]. Ryff’s psychological dimensions of well-being [48,49,50] may be instrumental in assessing recovery and in leading to self-therapy [2, 42]. George Engel defined etiologic factors as ‘factors which either place a burden on or limit the capacity of systems concerned with growth, development or adaptation’ [[51], p. 473].…”

Section: Drawing a Road Mapmentioning

confidence: 99%

“…In those days, the interest on the topic was minimal, response was mistaken for recovery, and an unsubstantiated optimism on the therapeutic effects of drug treatment was prevalent. A decade later, an update of that review as to major depression [2] disclosed an upsurge of literature on the topic, that residual symptoms and partial remission were the rule after successful remission, and that increasing the level of remission was the big task and challenge of psychiatry. The growing awareness of the pharmaceutical industry that this is the arena where marketing strategies are going to yield considerable returns has been instrumental for this increased attention.…”

Section: Introductionmentioning

confidence: 99%

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The Road to Recovery from Depression – Don’t Drive Today with Yesterday’s Map

Fava¹,

Tomba²,

Grandi³

2007

Psychother Psychosom

Self Cite

103

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The issue of recovery is getting increasing attention in depression research, particularly after the publication of the STAR*D results. The paper analyzes some issues which may hinder effective treatment of major depressive disorders: the inadequacies of a cross-sectional DSM assessment without clinical differentiation of the extent, development and seriousness of the disturbances (staging); over-emphasis on and prolongation of drug treatment, without paying attention to problems related to tolerance; neglect of the active role of the patient in achieving recovery, with the integration of psychotherapeutic strategies in a sequential model. If we are able to remove the conceptual obstacles which obstruct our view of depression and silence the sound of propaganda, we may then become aware of a different scenario in mood disorders and be able to develop therapeutic strategies of enduring quality.

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“…16 In their current report, 12 the authors demonstrate that patients who achieve 4 consecutive weeks of an asymptomatic state fared far better in their recovery than those who never improved beyond the SSD level. Asymptomatically recovered patients had a median time to full MDE recurrence of a little over 4 years, which was 2.5 times longer than the persistent It is illegal to post this copyrighted PDF on any website.…”

mentioning

confidence: 55%