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Change in psychosocial functioning and depressive symptoms during acute-phase cognitive therapy for depression

Published online by Cambridge University Press:  25 July 2011

T. W. Dunn ,
J. R. Vittengl ,
L. A. Clark ,
T. Carmody ,
M. E. Thase  and
R. B. Jarrett
T. W. Dunn
Affiliation:
The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
J. R. Vittengl*
Affiliation:
Truman State University, Kirksville, MO, USA
L. A. Clark
Affiliation:
University of Iowa, Iowa City, IA, USA
T. Carmody
Affiliation:
The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
M. E. Thase
Affiliation:
University of Pennsylvania, Philadelphia, PA, USA
R. B. Jarrett*
Affiliation:
The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
*
*Address for correspondence: Dr J. R. Vittengl, Department of Psychology, Truman State University, 100 East Normal Street, Kirksville, MO 63501-4221, USA. (Email: [email protected])
(Email: [email protected])
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Abstract

Background

Major depressive disorder (MDD) is highly prevalent, is recurrent, and impairs people's work, relationships and leisure. Acute-phase treatments improve psychosocial impairment associated with MDD, but how these improvements occur is unclear. In this study, we tested the hypotheses that reductions in depressive symptoms exceed, precede and predict improvements in psychosocial functioning.

Method

Patients with recurrent MDD (n=523; 68% women, 81% Caucasian, mean age 42 years) received acute-phase cognitive therapy (CT). We measured functioning and symptom severity with the Social Adjustment Scale – Self-Report (SAS-SR), Range of Impaired Functioning Tool (RIFT), Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HAMD) and Inventory for Depressive Symptomatology – Self-Report (IDS-SR). We tested cross-lagged correlations between functioning and symptoms measured at baseline and the beginning, middle and end of acute-phase CT.

Results

Pre- to post-treatment improvement in psychosocial functioning and depressive symptoms was large and intercorrelated. Depressive symptoms improved more and sooner than did psychosocial functioning. However, among four assessments across the course of treatment, improvements in functioning more strongly predicted later improvement in symptoms than vice versa.

Conclusions

Improvements in psychosocial functioning and depressive symptoms correlate substantially during acute-phase CT, and improvements in functioning may play a role in subsequent symptom reduction during acute-phase CT.

Keywords

Cognitive therapymajor depressive disorderpsychosocial functioning
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 2 , February 2012 , pp. 317 - 326
Copyright
Copyright © Cambridge University Press 2011

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