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Depression-related impairment: estimating concurrent and lingering effects

Published online by Cambridge University Press:  09 July 2009

Dan L. Tweed*
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
*
1Address for correspondence: Dr Dan L. Tweed, Department of Psychiatry, Duke University Medical Center, Box 3454, Durham, North Carolina 27710, USA.

Synopsis

This article examines the effects of depression in the sphere of social functioning. On the basis of previous research, it is hypothesized that a major depressive episode has both concurrent and lingering effects and that these effects are a function of the clinical features associated with the episode. This hypothesis is examined using a large community sample and a non-linear model containing both concurrent and lingering effect parameters. The results corroborate the hypothesized effects. Limitations of the current study are discussed and suggestions are offered regarding appropriate research designs. It is suggested that the most general limitation is theoretical. The existence of lingering effects is a phenomenon which presents a theoretical challenge that may prove strategic in understanding the nature and course of depression.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

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References

Akiskal, H. (1988). Personality as a mediating variable in the pathogenesis of mood disorders: implications for theory, research and prevention. In Depressive Illness: Prediction of Course and Outcome (ed. Helgason, T. and Daly, R.), pp. 131146. Springer-Verlag: Berlin.CrossRefGoogle Scholar
Akiskal, H. & McKinney, W. (1973). Depressive disorders toward a unified hypothesis. Science 182, 2029.CrossRefGoogle Scholar
Akiskal, H. & McKinney, W. (1975). Overview of recent research in depression: integration of ten conceptual models into a comprehensive clinical frame. Archives of General Psychiatry 32, 285305.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.American Psychiatric Association: Washington, DC.Google Scholar
Angst, J. (1988). Clinical course of affective disorders. In Depressive Illness: Prediction of Course and Outcome (ed. Helgason, T. and Daly, R.), pp. 144. Springer-Verlag: Berlin.Google Scholar
Beck, A. (1976). Cognitive Therapy and the Emotional Disorders. International University Press: New York.Google Scholar
Blumenthal, M. & Dielman, T. (1975). Depressive symptomatology and role function in the general population. Archives of General Psychiatry 32, 985991.CrossRefGoogle Scholar
Bothwell, S. & Weissman, M. (1977). Social impairments four years after an acute depressive episode. American Journal of Orthopsychiatry 47, 231237.CrossRefGoogle ScholarPubMed
Bouras, N., Vanger, P. & Bridges, P. (1986). Marital problems in chronically depressed and physically ill patients and their spouses. Comprehensive Psychiatry 27, 127130.CrossRefGoogle ScholarPubMed
Bradburn, N., Rips, L. & Shevell, S. (1987). Answering auto-biographical questions: the impact of memory and inference on surveys. Science 236, 157161.CrossRefGoogle Scholar
Broadhead, W., Blazer, D., George, L. & Tse, C. (1990). Depression, disability days, and days lost from work in a prospective epidemiologic survey. Journal of the American Medical Association 21, 25242528.CrossRefGoogle Scholar
Carson, T. & Carson, R. (1984). The affective disorders. In Comprehensive Handbook of Psychopathology (ed. Adams, H. and Sutker, P.), pp. 349381. Plenum Press: New York.CrossRefGoogle Scholar
Charney, E. & Weissman, W. (1988). Epidemiology of depressive illness. In Phenomenology of Depressive Illness: Volume I (ed. Mann, J.), pp. 4574. Human Sciences Press: New York.Google Scholar
Coyne, J., Kessler, R., Tal, M., Turnbull, J., Wortman, C. & Greden, J. (1987). Living with a depressed person. Journal of Consulting and Clinical Psychology 55, 347352.CrossRefGoogle ScholarPubMed
Coyne, J., Wortman, C. & Lehman, D. (1988). The other side of support: emotional overinvolvement and miscarried helping. In Social Support: Formats, Processes, and Effects (ed. Gottlieb, B.), pp. 137154. Sage: New York.Google Scholar
Craig, T. & Van Natta, P. (1983). Disability and depressive symptoms in two communities. American Journal of Psychiatry 140, 598601.Google ScholarPubMed
Frank, E., Prien, R., Jarrett, R., Keller, M., Kupfer, D., Lavori, P., Rush, A. & Weissman, M. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Archives of General Psychiatry 48, 851855.CrossRefGoogle ScholarPubMed
Fredrichs, R., Aneshensel, C., Yokopenic, P. & Clark, V. (1982). Physical health and depression: an epidemiology survey. Preventative Medicine 11, 639646.Google Scholar
Hammen, C. (1990). Vulnerability to depression: personal, situational and family aspects. In Contemporary Psychological Approaches to Depression (ed. Ingram, R.), pp. 5970. Plenum Press: New York.CrossRefGoogle Scholar
Hammen, C. (1991). Depression Runs in the Family Springer-Verlag: Berlin.Google Scholar
Hirschfeld, R., Klerman, G., Lavori, P., Keller, M., Griffith, P. & Coryell, W. (1989). Premorbid personality assessments of first onset of major depression. Archives of General Psychiatry 46, 345350.CrossRefGoogle ScholarPubMed
Ingram, R. (1990). An interpersonal systems approach to the conceptualization and treatment of depression. In Contemporary Psychological Approaches to Depression: Theory, Research, and Treatment (ed. Ingram, R.), pp. 137154. Plenum Press: New York.CrossRefGoogle Scholar
Kish, L. (1949). A procedure for objective respondent selection within the household. Journal of the American Statistical Association 44, 380387.CrossRefGoogle Scholar
Klerman, G. (1989). Depressive disorders: further evidence for increased medical morbidity and impairment of social functioning. Archives of General Psychiatry 46, 856858.Google ScholarPubMed
Klerman, G. & Weissman, M. (1986). The interpersonal approach to understanding depression. In Contemporary Directions in Psychopathology: Toward the DSM-IV (ed. Millon, T. and Klerman, G.), pp. 429456. Guilford Press: New York.Google Scholar
Liberman, R. (1988). Psychiatric Rehabilitation of Chronic Mental Patients. American Psychiatric Press: Washington, DC.Google Scholar
Merikangas, K. (1984). Divorce and assortive mating among depressed patients. American Journal of Psychiatry 141, 7476.Google ScholarPubMed
Mirowsky, J. & Ross, K. (1989). Psychiatric diagnosis as reified measurement. Journal of Health and Social Behavior 30, 1125.CrossRefGoogle ScholarPubMed
Paykel, E., Weissman, M. & Prusoff, B. (1978). Social maladjustment and severity of depression. Comprehensive Psychiatry 19, 121128.CrossRefGoogle ScholarPubMed
Puig-Antick, J., Lukens, E., Davies, M., Goetz, C., Brennan-Quattrock, J. & Todak, G. (1985 a). Psychosocial functioning in prepubertal major depressive disorders. I. Interpersonal relation-ships during the depressive episode. Archives of General Psychiatry 42, 500507.CrossRefGoogle Scholar
Puig-Antick, J., Lukens, E., Davies, M., Goetz, C., Brennan-Quattrock, J. & Todak, G. (1985 b). Psychosocial functioning in prepubertal major depressive disorders. 2. Interpersonal relationships after sustained recovery from affective episode. Archives of General Psychiatry 42, 511517.CrossRefGoogle Scholar
Rhode, P., Lewinsohn, P. & Seeley, J. (1990). Are people changed by the experience of having an episode of depression? A further test of the scar hypothesis. Journal of Abnormal Psychology 99, 264271.CrossRefGoogle Scholar
Schless, A., Schartz, L., Goetz, C. & Mendels, J. (1974). How depressives view the significance of life events. British Journal of Psychiatry 125, 406410.Google ScholarPubMed
Tennant, C., Bebbington, P. & Hurry, J. (1981). The role of life events in depressive illness: Is there a substantial causal relation? Psychological Medicine 11, 379389.CrossRefGoogle Scholar
Wells, K., Golding, J. & Burnam, M. (1988). Psychiatric disorder and limitations in physical functioning in a general population. American Journal of Psychiatry 145, 712717.Google Scholar
Wells, K., Stewart, A., Hays, R., Burnam, M., Rogers, W., Daniels, M., Berry, S., Greenfield, S. & Ware, J. (1989). The functioning and well-being of depressed patients: results from the medical outcomes study. Journal of the American Medical Association 262, 914919.CrossRefGoogle ScholarPubMed
Willner, P. (1985). Depression: A Psychobiological Synthesis. John Wiley and Sons: New York.Google Scholar
Zeiss, A. & Lewinsohn, P. (1988). Enduring deficits after remission of depression: a test of the ‘scar’ hypothesis. Behavior Research and Therapy 26, 151158.CrossRefGoogle ScholarPubMed