title: Determinants of functional disability and social adjustment in major depressive disorder: a prospective study.
abstract: We examined prospectively factors influencing social and occupational disability and social adjustment among patients with major depressive disorder. The Vantaa Depression Study comprises a cohort of psychiatric inpatients and outpatients with major depressive disorder in the city of Vantaa, Finland. We prospectively interviewed 193 of 269 (72%) patients both 6 and 18 months after baseline. Axis I and II diagnoses were assessed via semistructured WHO Schedules for Clinical Assessment in Neuropsychiatry 2.0 and SCID-II interviews. Global disability and social and work adjustment were assessed. Patients' functional disability and social adjustment were alleviated concurrently with recovery from depression during the follow-up. The current level of functioning and social adjustment of a patient with depression was predicted by severity of depression, recurrence before baseline and during follow-up, lack of full remission, and time spent depressed. Comorbid psychiatric disorders, personality traits (neuroticism), and perceived social support had significant influence.
authors.affiliation: Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
authors.forename: Heikki J
authors.initials: HJ
authors.lastname: Rytsälä
authors.forename: Tarja K
authors.initials: TK
authors.lastname: Melartin
authors.forename: Ulla S
authors.initials: US
authors.lastname: Leskelä
authors.forename: Paula S
authors.initials: PS
authors.lastname: Lestelä-Mielonen
authors.forename: T Petteri
authors.initials: TP
authors.lastname: Sokero
authors.forename: Erkki T
authors.initials: ET
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment; D012938:Social Perception; D012944:Social Support; D016896:Treatment Outcome