title: Explaining functional outcomes in depression treatment: a multilevel modelling approach.
abstract: BACKGROUND
  The main aim of this study is to investigate the role that social, environmental and personal factors play in explaining change in function in patients with major depressive disorder (MDD).
  
  
  METHODS
  The sample of the current study comes from a naturalistic and prospective cohort study of patients starting antidepressant treatment in one distinct health area of Madrid. A total of 97 adults (18 years or older) with MDD have been followed up three points in time and evaluated with the WHO_DAS II and instruments that assessed socio-demographic characteristics, clinical and contextual factors. Data were analysed using multilevel modelling statistical approach to repeated measures data.
  
  
  RESULTS
  Change of severity of depression symptoms was the main explanatory factor for change in patient's functioning, accounting for 32% of the variance of functioning over time. Contextual factors (environmental and personal variables), including gender, work status, societal attitudes, health satisfaction and quality of life accounted for 20% of the functioning variance after controlling for the effect of health condition variables.
  
  
  CONCLUSIONS
  Social, environmental and personal factors seem to play a significant role in explaining depressed patients' functioning after controlling for health condition/medical factors.
authors.affiliation: Departamento de Psiquiatría, Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Hesham F
authors.initials: HF
authors.lastname: Gadelrab
authors.forename: Maria
authors.initials: M
authors.lastname: Cabello
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Jesus
authors.initials: J
authors.lastname: Valle
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.forename: José Luís
authors.initials: JL
authors.lastname: Ayuso-Mateos
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012931:Social Environment; D016896:Treatment Outcome; D014837:Voluntary Health Agencies
chemical_list: D000928:Antidepressive Agents