Social functioning in depression: a review.
OBJECTIVE
This article reviews the available data on social functioning in depression and provides clinical guidelines and opinion on this important and expanding field.


METHODS
A MEDLINE search was conducted to identify all English-language articles (1988-1999) using the search terms depression and social functioning, depression and social adjustment, depression and psychosocial functioning, and social functioning and antidepressant. Further articles were obtained from the bibliographies of relevant articles.


RESULTS
Depressive disorders are frequently associated with significant and pervasive impairments in social functioning, often substantially worse than those experienced by patients with other chronic medical conditions. The enormous personal, social, and economic impact of depression, due in no small part to the associated impairments in social functioning, is often underappreciated. Both pharmacologic and psychotherapeutic approaches can improve social impairments, although there is a lack of extended, randomized controlled trials in this area using consistent assessment criteria.


CONCLUSIONS
Despite this lack, it is becoming clear that not all treatments are equally effective in relieving the impaired social functioning associated with depressive disorders. Furthermore, efficacy in relieving the core symptoms of depression does not necessarily guarantee efficacy in relieving impaired social functioning.
Hirschfeld
R M
RM
Department of Psychiatry & Behavioral Sciences, University of Texas Medical Branch, Galveston 77555-0188, USA.
Montgomery
S A
SA
Keller
M B
MB
Kasper
S
S
Schatzberg
A F
AF
Möller
H J
HJ
Healy
D
D
Baldwin
D
D
Humble
M
M
Versiani
M
M
Montenegro
R
R
Bourgeois
M
M
D000223:Adaptation, Psychological; D000928:Antidepressive Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017281:Cost of Illness; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D006304:Health Status; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy; D011788:Quality of Life; D012107:Research Design; D020280:Sertraline / Q000627:therapeutic use; D012917:Social Adjustment; D016896:Treatment Outcome
D000928:Antidepressive Agents; D007099:Imipramine; D020280:Sertraline