Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-27T20:57:28.738Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term disability in major depressive disorder: a 6-year follow-up study

Published online by Cambridge University Press:  09 July 2019

Sorana C. Iancu Open the ORCID record for Sorana C. Iancu [Opens in a new window] ,
Yak Mee Wong ,
Didi Rhebergen ,
Anton J. L. M. van Balkom  and
Neeltje M. Batelaan
Sorana C. Iancu*
Affiliation:
Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
Yak Mee Wong
Affiliation:
Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Didi Rhebergen
Affiliation:
Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
Anton J. L. M. van Balkom
Affiliation:
Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
Neeltje M. Batelaan
Affiliation:
Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
*
Author for correspondence: Sorana C. Iancu, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Major depressive disorder (MDD) represents a leading cause of disability. This study examines the course of disability in patients with chronic, recurrent and remitting MDD compared to healthy controls and identifies predictors of disability in remitting MDD.

Methods

We included 914 participants from the Netherlands Study of Depression and Anxiety (NESDA). DSM-IV MDD and WHO DAS II disability were assessed at baseline and at 2, 4 and 6 years. Six-year total and domain-specific disability were analysed and compared in participants with chronic (n = 57), recurrent (n = 120), remitting (n = 127) MDD and in healthy controls (n = 430). Predictors of residual disability were identified using linear regression analysis.

Results

At baseline, most disability was found in chronic MDD, followed by recurrent MDD, remitting MDD and healthy controls. Across diagnostic groups, most disability was found in household activities, interpersonal functioning, participation in society and cognition. A chronic course was associated with chronic disability. Symptom remission was associated with a decrease in disability, but some disability remained. In remitting MDD, higher residual disability was predicted by older age, more severe avoidance symptoms, higher disability at baseline and late symptom remission. Severity of residual disability correlated with the severity of residual depressive symptoms.

Conclusions

Symptomatic remission is a prerequisite for improvements in disability. However, disability persists despite symptom remission. Therefore, treatment of MDD should include an explicit focus on disability, especially on the more complex domains. To this end, treatments should promote behavioural activation and address subthreshold depressive symptoms in patients with remitted MDD.

Keywords

Disabilitylongitudinalmajor depressive disorderpredictionremission
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 10 , July 2020 , pp. 1644 - 1652
Copyright
Copyright © Cambridge University Press 2019

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

Beck, AT, Epstein, N, Brown, G and Steer, RA (1988) An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893–897.CrossRefGoogle ScholarPubMed
Bos, EH, ten Have, M, van Dorsselaer, S, Jeronimus, BF, de Graaf, R and de Jonge, P (2018) Functioning before and after a major depressive episode: pre-existing vulnerability or scar? A prospective three-wave population-based study. Psychological Medicine 48, 2264–2272.CrossRefGoogle ScholarPubMed
Buist-Bouwman, MA, Ormel, J, De Graaf, R and Vollebergh, WAM (2004) Functioning after a major depressive episode: complete or incomplete recovery? Journal of Affective Disorders 82, 363–371.Google ScholarPubMed
Buist-Bouwman, MA, De Graaf, R, Vollebergh, WAM, Alonso, J, Bruffaerts, R and Ormel, J (2006) Functional disability of mental disorders and comparison with physical disorders: a study among the general population of six European countries. Acta Psychiatrica Scandinavica 113, 492–500.CrossRefGoogle ScholarPubMed
Cabello, M, Caballero, FF, Chatterji, S, Cieza, A and Ayuso-Mateos, JL (2014) Risk factors for incidence and persistence of disability in chronic major depression and alcohol use disorders: longitudinal analyses of a population-based study. Health and Quality of Life Outcomes 12, 186–198.CrossRefGoogle ScholarPubMed
Chopra, PK, Chopra, PK, Couper, JW and Herrman, H (2004) The assessment of patients with long-term psychotic disorders: application of the WHO Disability Assessment Schedule II. Australian & New Zealand Journal of Psychiatry 38, 753–759.CrossRefGoogle ScholarPubMed
Chwastiak, LA and Von Korff, M (2003) Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Journal of Clinical Epidemiology 56, 507–514.CrossRefGoogle Scholar
Coryell, W, Scheftner, W, Keller, M, Endicott, J, Maser, J and Klerman, GL (1993) The enduring psychosocial consequences of mania and depression. American Journal of Psychiatry 150, 720–727.Google ScholarPubMed
Costa, PT and McCrae, RR (1995) Domains and facets: hierarchical personality assessment using the revised NEO personality inventory. Journal of Personality Assessment 64, 21–50.CrossRefGoogle ScholarPubMed
Ferrari, AJ, Charlson, FJ, Norman, RE, Patten, SB, Freedman, G, Murray, CJL, Vos, T and Whiteford, HA (2013) Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Medicine 10, e1001547.CrossRefGoogle ScholarPubMed
Field, A (2009) Discovering Statistics Using SPSS, 3rd Edn.London: Sage Publications.Google Scholar
Fried, EI and Nesse, RM (2014) The impact of individual depressive symptoms on impairment of psychosocial functioning. PLoS ONE 9, e90311.CrossRefGoogle ScholarPubMed
GBD 2015 Mortality and Causes of Death Collaborators (2016) Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 388, 1459–1544.CrossRefGoogle Scholar
Gelenberg, AJ (2010) The prevalence and impact of depression. The Journal of Clinical Psychiatry 71, e06.CrossRefGoogle ScholarPubMed
Greer, TL, Kurian, BT and Trivedi, MH (2010) Defining and measuring functional recovery from depression. CNS Drugs 24, 267–284.CrossRefGoogle ScholarPubMed
Hays, RD, Wells, KB, Sherbourne, CD, Rogers, W and Spritzer, K (1995) Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Archives of General Psychiatry 52, 11–19.CrossRefGoogle ScholarPubMed
Hendriks, SM, Spijker, J, Licht, CMM, Hardeveld, F, de Graaf, R, Batelaan, NM, Penninx, BWJH and Beekman, ATF (2016) Long-term disability in anxiety disorders. BMC Psychiatry 16, 248–255.CrossRefGoogle ScholarPubMed
Hirschfeld, RMA, Dunner, DL, Keitner, G, Klein, DN, Koran, LM, Kornstein, SG, Markowitz, JC, Miller, I, Nemeroff, CB, Ninan, PT, Rush, AJ, Schatzberg, AF, Thase, ME, Trivedi, MH, Borian, FE, Crits-Christoph, P and Keller, MB (2002) Does psychosocial functioning improve independent of depressive symptoms? A comparison of nefazodone, psychotherapy, and their combination. Biological Psychiatry 51, 123–133.CrossRefGoogle ScholarPubMed
Iancu, SC, Batelaan, NM, Zweekhorst, MBM, Bunders, JFG, Veltman, DJ, Penninx, BWJH and Van Balkom, AJLM (2014) Trajectories of functioning after remission from anxiety disorders: 2-year course and outcome predictors. Psychological Medicine 44, 593–605.CrossRefGoogle ScholarPubMed
IBM Corp. (2016) IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.Google Scholar
Judd, LL, Akiskal, HS, Zeller, PJ, Paulus, M, Leon, AC, Maser, JD, Endicott, J, Coryell, W, Kunovac, JL, Mueller, TI, Rice, JP and Keller, MB (2000) Psychosocial disability during the long-term course of unipolar major depressive disorder. Archives of General Psychiatry 57, 375–380.CrossRefGoogle ScholarPubMed
Kamenov, K, Caballero, FF, Miret, M, Leonardi, M, Sainio, P, Tobiasz-Adamczyk, B, Haro, JM, Chatterji, S, Ayuso-Mateos, JL and Cabello, M (2016) Which are the most burdensome functioning areas in depression? A cross-national study. Frontiers in Psychology 7, 1–9.CrossRefGoogle ScholarPubMed
Karsten, J, Hartman, CA, Ormel, J, Nolen, WA and Penninx, BWJH (2010) Subthreshold depression based on functional impairment better defined by symptom severity than by number of DSM-IV symptoms. Journal of Affective Disorders 123, 230–237.CrossRefGoogle ScholarPubMed
Katon, W (2009) The impact of depression on workplace functioning and disability costs. The American Journal of Managed Care 15, S322–S327.Google ScholarPubMed
Kempen, GIJM, van Heuvelen, MJG, van den Brink, RHS, Kooijman, AC, Klein, M, Houx, PJ and Ormel, J (1996) Factors affecting contrasting results between self-reported and performance-based levels of physical limitations. Age and Ageing 25, 458–464.CrossRefGoogle Scholar
Konecky, B, Meyer, EC, Marx, BP, Kimbrel, NA and Sandra, B (2014) Using the WHODAS 2.0 to assess functional disability associated with mental disorders. American Journal of Psychiatry 171, 818–820.CrossRefGoogle ScholarPubMed
Kruijshaar, ME, Hoeymans, N, Bijl, RV, Spijker, J and Essink-Bot, ML (2003) Levels of disability in major depression: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of Affective Disorders 77, 53–64.CrossRefGoogle Scholar
Marks, IM and Mathews, AM (1979) Brief standard self-rating for phobic patients. Behaviour Research and Therapy 17, 263–267.CrossRefGoogle ScholarPubMed
McKnight, PE and Kashdan, TB (2009) The importance of functional impairment to mental health outcomes: a case for reassessing our goals in depression treatment research. Clinical Psychology Review 29, 243–259.CrossRefGoogle ScholarPubMed
Ormel, J (2000) Synchrony of change in depression and disability: what next? Archives of General Psychiatry 57, 381–382.CrossRefGoogle ScholarPubMed
Ormel, J, von Korff, M, van den Brink, W, Katon, W, Brilman, E and Oldehinkel, T (1993) Depression, anxiety, and social disability show synchrony of change in primary care patients. American Journal of Public Health 83, 385–390.CrossRefGoogle ScholarPubMed
Ormel, J, Oldehinkel, AJ, Nolen, WA and Vollebergh, W (2004) Psychosocial disability before, during, and after a major depressive episode: a 3-wave population-based study of state, scar, and trait effects. Archives of General Psychiatry 61, 387–392.CrossRefGoogle Scholar
Penninx, BWJH, Beekman, ATF, Smit, JH, Zitman, FG, Nolen, WA, Spinhoven, P, Cuijpers, P, De Jong, PJ, Van Marwijk, HWJ, Assendelft, WJJ, van der Meer, K, Verhaak, P, Wensing, M, de Graaf, R, Hoogendijk, WJ, Ormel, J and van Dyck, R (2008) The Netherlands Study of Depression and Anxiety (NESDA): Rationale, objectives and methods. International Journal of Methods in Psychiatric Research 17, 121–140.CrossRefGoogle ScholarPubMed
Perini, SJ, Slade, T and Andrews, G (2006) Generic effectiveness measures: sensitivity to symptom change in anxiety disorders. Journal of Affective Disorders 90, 123–130.CrossRefGoogle ScholarPubMed
Rhebergen, D, Beekman, ATF, de Graaf, R, Nolen, WA, Spijker, J, Hoogendijk, WJ and Penninx, BWJH (2010) Trajectories of recovery of social and physical functioning in major depression, dysthymic disorder and double depression: a 3-year follow-up. Journal of Affective Disorders 124, 148–156.CrossRefGoogle ScholarPubMed
Rush, AJ, Giles, DE, Schlesser, MA, Fulton, CL, Weissenburger, J and Burns, C (1986) The inventory for depressive symptomatology (IDS): preliminary findings. Psychiatry Research 18, 65–87.CrossRefGoogle ScholarPubMed
Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR and Grant, M (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction 88, 791–804.CrossRefGoogle ScholarPubMed
Smitten, HM, Smeets, RMW and Brink, W (1998). Composite International Diagnostic Interview (CIDI), Version 2.1, 12-months (in Dutch). Amsterdam/Geneva: World Health Organization.Google Scholar
Sobocki, P, Jönsson, B, Angst, J and Rehnberg, C (2006) Cost of depression in Europe. The Journal of Mental Health Policy and Economics 9, 87–98.Google ScholarPubMed
Spijker, J, De Graaf, R, Bijl, RV, Beekman, ATF, Ormel, J and Nolen, WA (2004 a) Determinants of persistence of major depressive episodes in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of Affective Disorders 81, 231–240.CrossRefGoogle Scholar
Spijker, J, Graaf, R, Bijl, RV, Beekman, ATF, Ormel, J and Nolen, WA (2004 b) Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatrica Scandinavica 110, 208–214.CrossRefGoogle Scholar
Von Korff, M, Ormel, J, Katon, W and Lin, EHB (1992) Disability and depression among high utilizers of health care: a longitudinal analysis. Archives of General Psychiatry 49, 91–100.CrossRefGoogle ScholarPubMed
Wacker, H, Battegay, R, Mullejans, R and Schlosser, C (2006) Using the CIDI-C in the general population. In Stefanis, CN, Rabavilas, AD and Soldatos, CR (eds), Psychiatry: A World Perspective. Amsterdam: Elsevier Science Publishers, pp. 138–143.Google Scholar
Weightman, MJ, Air, TM and Baune, BT (2014) A review of the role of social cognition in major depressive disorder. Frontiers in Psychiatry 5, 1–13.CrossRefGoogle ScholarPubMed
WHO (2001) International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization.Google Scholar
Wittchen, H (1989) Recall and dating of psychiatric symptoms. Archives of General Psychiatry 46, 437–443.CrossRefGoogle ScholarPubMed
Wittchen, H (1994) Reliability and validity studies of the WHO – Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 57–84.CrossRefGoogle ScholarPubMed
Wittchen, H, Robins, LN, Cottler, LB, Sartorius, N, Burke, JD and Regier, D (1991) Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field Trials. British Journal of Psychiatry 159, 645–665.CrossRefGoogle ScholarPubMed
Supplementary material: File

Iancu et al. supplementary material

Table S2

Download Iancu et al. supplementary material(File)
File 44.9 KB
Supplementary material: File

Iancu et al. supplementary material

Table S1

Download Iancu et al. supplementary material(File)
File 18.9 KB