Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-02T19:08:55.295Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial functioning in patients with treatment resistant depression

Published online by Cambridge University Press:  16 April 2020

Timothy Petersen ,
George I. Papakostas ,
Yasmin Mahal ,
Wendy M. Guyker ,
Erin C. Beaumont ,
Jonathan E. Alpert ,
Maurizio Fava  and
Andrew A. Nierenberg
Timothy Petersen*
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
George I. Papakostas
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Yasmin Mahal
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Wendy M. Guyker
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Erin C. Beaumont
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Jonathan E. Alpert
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Maurizio Fava
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
Andrew A. Nierenberg
Affiliation:
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital, 15 Parkman Street, WAC 812Boston, MA 02114, USA
*
*Corresponding author. [email protected] (T. Petersen).
Get access

Abstract

Background

Depression is a disorder that causes disability, with a profound adverse impact on all areas of psychosocial functioning. This is particularly true for those with treatment resistant depression (TRD). However, to date, no systematic assessments of psychosocial functioning for patients with TRD have been conducted.

Methods

In the present study, we used the Longitudinal Interval Follow-up Evaluation (LIFE) scale to measure psychosocial functioning in 92 patients with TRD. These patients met formal criteria for TRD and were part of a clinical trial examining the efficacy of lithium augmentation of nortriptyline.

Results

Clinicians rated this sample of patients as experiencing mild to moderate impairment in work-related activities, good to fair interpersonal relations, poor level of involvement in recreational activities, and mild impairment of ability to enjoy sexual activity. Patients and clinicians rated global social adjustment as poor.

Conclusions

Patients with formally defined TRD experience significant impairment in psychosocial functioning. In this sample a tendency existed for both clinicians and patients to assign more severely impaired global ratings when compared with ratings for specific functional areas.

Keywords

Treatment resistant depressionPsychosocial functioning
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 4 , June 2004 , pp. 196 - 201
Copyright
Copyright © European Psychiatric Association 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, HS.Factors associated with incomplete recovery in primary depressive illness. J Clin Psychiatry 1982;43:266–71.Google ScholarPubMed
Beck, ATKovacs, MWeissman, A.Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol 1979;47(2): 343–52.CrossRefGoogle ScholarPubMed
Broadhead, WEBlazer, DGGeorge, LKTse, CK.Depression, disability days, and days lost from work in a prospective epidemiological survey. JAMA 1990;264:2524–8.CrossRefGoogle Scholar
Covi, LLipman, RSAlarcon, RSmith, VK.Drug and psychotherapy interactions in depression. Am J Psychiatry 1976;133:502–8.Google ScholarPubMed
Downing, RWRickels, K.Predictors of amitriptyline response in outpatient depressives. J Nerv Ment Dis 1972;154:248–63.CrossRefGoogle ScholarPubMed
Fava, MKaji, JDavidson, K.Pharmacologic strategies for treatment resistant major depression. In: Pollack, MHOtto, MWRosenbaum, JF editors. Challenges in clinical practice: pharmacologic and psychosocial strategies. New York: The Guilford Press; 1996.Google Scholar
Fava, MDavidson, KG.Definition and epidemiology of treatment-resistant depression. Psychiatr Clin North Am 1996;19(2):179–200.CrossRefGoogle ScholarPubMed
George, LKBlazer, DGHughes, DCFowler, N.Social support and the outcome of major depression. Br J Psychiatry 1989;154:478–85.CrossRefGoogle ScholarPubMed
Greden, JF.The burden of disease for treatment-resistant depression. J Clin Psychiatry 2001;62(Suppl 16):26–31.Google ScholarPubMed
Greenberg, PEStiglin, LEFinkelstein, SNBerndt, ER.The economic burden of depression in 1990. J Clin Psychiatry 1993;54:405–18.Google ScholarPubMed
Hamilton, M.A rating scale of depression. J Neurol Neurosurg Psy chiatry 1960;23:56–62.CrossRefGoogle Scholar
Hirschfeld, RMRussell, JMDelgado, PLFawcett, JFriedman, RAHarrison, WMet al. Predictors of response to acute treatment of chronic and double depression with sertraline or imipramine. J Clin Psychiatry 1998;59(12):669–75.CrossRefGoogle ScholarPubMed
Kaplan, RMAnderson, JP.The general health policy model: an integrated approach. 2nd ed. In: Spilker, B editor. Quality of life and pharmacoeconomics in clinical trials. Philadelphia, PA: Lippincott-Raven; 1996. p. 309–21.Google Scholar
Keitner, GIRyan, CEMiller, IWNormand, WH.Recovery and major depression: factors associated with twelve-month outcome. Am J Psychiatry 1992;149:93–9.Google ScholarPubMed
Keller, MB.The longitudinal interval follow-up evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Arch Gen Psychiatry 1987;44:540–8.CrossRefGoogle ScholarPubMed
Keller, MBKlerman, GLLavori, PW.Long term outcome of episodes of major depression. JAMA 1984;252:788–92.CrossRefGoogle ScholarPubMed
Keller, MBLavori, PWMcDonald-Scott, PEndicott, JAndreasen, NVan Eerdewegh, MM.The reliability of retrospective treatment reports. Psychiatry Res 1983;9:81–8.CrossRefGoogle ScholarPubMed
Keller, MBLavori, PWMueller, TIEndicott, JCoryell, WHir-schfeld, RMet al. Time to recovery, chronicity, and levels of psycho-pathology in major depression. A 5 year prospective follow-up of 431 subjects. Arch Gen Psychiatry 1992;49(16):809–16.CrossRefGoogle Scholar
Kessler, RCBarber, CBirnbaum, HCFrank, RGGreenberg, PERose, RMet al. Depression in the workplace: effects on short-term disability. Health Aff (Millwood) 1999;18:163–71.CrossRefGoogle ScholarPubMed
Koivumaa-Honkanen, HHonkanen, RAntikainen, RHintikka, JLaukkanen, EHonkalampi, Ket al. Self-reported life satisfaction and recovery from depression in a1-year prospective study. Acta Psychiatr Scand 2001;103(1):38–44.CrossRefGoogle Scholar
Kornstein, SGSchneider, RK.Clinical features of treatment-resistant depression. J Clin Psychiatry 2001;62(Suppl 16):18–25.Google ScholarPubMed
Mischoulon, D.An approach to the patient seeking psychiatric disability benefits. J Am Acad Psychiatry Law 1999;23(3):128–36.CrossRefGoogle Scholar
Moos, RH.Depressed outpatients’ life contexts, amount of treatment, and treatment outcome. J Nerv Ment Dis 1990;178:105–12.Google ScholarPubMed
Murray, CJLLopez, AD.Alternative projections of mortality and disability by cause. 1990–2020: global burden of disease study. Lancet 1997;349:1498–504.CrossRefGoogle ScholarPubMed
Murray CJL, Lopez, AD.Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet 1997b; 349:1436–42.Google Scholar
Nierenberg, AAKeck, PESamson, JRothschild, AJSchatzberg, AF.Methodologic considerations for the study of treatment-resistant depression. In: Amsterdam, JD editor. Refractory depression. New York: Raven Press; 1991. p. 217–44.Google Scholar
Ormel, JVon Korff, MOldehinkel, AJSimon, GTiemens, BGUstun, TB.Onset of disability in depressed and non-depressed primary care patients. Psych Med 1999;29:847–53.CrossRefGoogle ScholarPubMed
Parikh, SVWasylenki, DGoering, PWong, J.Mood disorders: rural/urban differences in prevalence, health care utilization, and disability in Ontario. J Affect Dis 1996;38:57–65.CrossRefGoogle ScholarPubMed
Parikh, SVLam, RWCANMAT Depression Work Group. Clinical guidelines for the treatment of depressive disorders. I. Definitions, prevalence and health burden. Can J Psychiatry 2001;46(1):13S–20S.Google ScholarPubMed
Price, LHCharney, DSHeninger, GR.Variability of response to lithium augmentation in refractory depression. Am J Psychiatry 1986; 143:1387–92.Google ScholarPubMed
Pyne, JMBullock, DKaplan, RMSmith, TLGillin, CGolshan, Set al. Health-related quality of life measures enhances acute treatment response prediction in depressed inpatients. J Clin Psychiatry 2001;62:261–8.CrossRefGoogle Scholar
Roundaville, BJWeissman, MMPrusoff, BAHerceg-Baron, RL.Marital disputes and treatment outcome in depressed women. Comp Psychiatry 1979;20:483–90.CrossRefGoogle Scholar
Rost, KZhang, MFortney, JSmith, JSmith, G.Expenditures for the treatment of major depression. Am J Psychiatry 1998;155(7):883–8.Google ScholarPubMed
Riise, TLund, A.Prognostic factors in major depression: a long-term follow-up study of 323 patients. J Affect Dis 2001;65(3):297–306.CrossRefGoogle ScholarPubMed
Rodriguez, EFrongillo, EAChandra, P.Do social programmes contribute to mental well-being? The long-term impact of unemployment on depression in the United States. Int J Epidemiol 2001;30:163–70.CrossRefGoogle ScholarPubMed
Scott, JBarker, WAEccleston, D.The Newcastle chronic depression study. Patient characteristics and factors associated with chronicity. Br J Psychiatry 1988;152:28–33.CrossRefGoogle ScholarPubMed
Simon, GEVonKorff, MBarlow, W.Health care costs of primary care patients with recognized depression. Arch Gen Psychiatry 1995;52: 850–6.CrossRefGoogle ScholarPubMed
Skodol, AEGunderson, JGMcGlashan, THDyck, IRStout, RLBender, DSet al. Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. Am J Psychiatry 2002;159(2):276–83.CrossRefGoogle ScholarPubMed
Spitzer, RLWilliams, JBGibbon, MFirst, MB.Structured Clinical Interview for DSM-III-R-Patient edition (SCID-P). New York: New York State Psychiatric Institute, Biometrics Research Department; 1989.Google Scholar
Vallejo, JGasto, CCatalan, RBulbena, AMenchon, JM.Predictors of antidepressant treatment outcome in melancholia: psychosocial, clinical and biological indicators. J Affect Dis 1991;21:151–62.CrossRefGoogle ScholarPubMed
Weissman, MM.Social functioning and the treatment of depression. J Clin Psychiatry 2000;61(Suppl 1):33–8.Google ScholarPubMed
Wells, KStewart, AHays, RDBurman, ARogers, WDaniels, Met al., Results from the Medical Outcomes Study. The function and well-being of depressed patients. JAMA 1989;262(7):914–9.CrossRefGoogle Scholar
Wells, KBStrom, RSherbourne, CDMeredith, LS.Caring for depression: a RAND study. Cambridge: Harvard University Press; 1996.Google Scholar
Submit a response

Comments

No Comments have been published for this article.