title: Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses.
abstract: BACKGROUND
  Cross-sectional studies have found that depression is uniquely associated with limitations in well-being and functioning that were equal to or greater than those of chronic general medical conditions such as diabetes and arthritis. However, whether these relative limitations persist over time is not known.
  
  
  METHODS
  We conducted a 2-year observational study of 1790 adult outpatients with depression, diabetes, hypertension, recent myocardial infarction, and/or congestive heart failure. Change in functional status and well-being was compared for depressed patients vs patients with chronic general medical illnesses, controlling statistically for medical comorbidity, sociodemographics, system, and specialty of care.
  
  
  RESULTS
  Over 2 years of follow-up, limitations in functioning and well-being improved somewhat for depressed patients; even so, at the end of 2 years, these limitations were similar to or worse than those attributed to chronic medical illnesses. Similar patterns were observed for depressed patients in the mental health specialty sector and those in the general medical sector, but the patients in the mental health specialty sector improved more. More severely depressed patients improved more in functioning, but even initially depressed patients without depressive disorder had substantial persistent limitations.
  
  
  CONCLUSIONS
  Depressed patients have substantial and long-lasting decrements in multiple domains of functioning and well-being that equal or exceed those of patients with chronic medical illnesses.
authors: RAND, Santa Monica, Calif.
authors: R D
authors: RD
authors: Hays
authors: K B
authors: KB
authors: Wells
authors: C D
authors: CD
authors: Sherbourne
authors: W
authors: W
authors: Rogers
authors: K
authors: K
authors: Spritzer
mesh_terms: D000203:Activities of Daily Living; D000553:Ambulatory Care; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment; D016896:Treatment Outcome