Moderators of the synchrony of change between decreasing depression severity and disability

Abstract

Moderators of the synchrony of change between decreasing depression severity and disability Verboom, C. E.; Ormel, J.; Nolen, W. A.; Penninx, B. W. J. H.; Sijtsema, J. J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 27-04-2019Moderators of the synchrony of change between decreasing depression severity and disability Verboom CE, Ormel J, Nolen WA, Penninx BWJH, Sijtsema JJ. Moderators of the synchrony of change between decreasing depression severity and disability.Objective: To identify moderators of synchrony of change between depression severity and disability. Method: From a large cohort study with 2 years of follow-up, patients with major depressive disorder at baseline who decreased at least 25% in depression severity after 2 years (n = 245) were selected. We measured overall and domain-specific disability at baseline, and at 1-and 2-year follow-up. Possible moderators, among which several demographic, clinical, personality, and contextual factors, were measured at baseline. We used linear mixed models to analyze the data. Results: Decrease in depression severity correlated strongly with reductions of overall disability (r = 0.54). Synchrony of change for the disability domains ranged from 0.13 for self-care to 0.47 for participation. From the possible moderators, only age and work stress moderated the association between change in depression severity and disability, with stronger synchrony of change among younger patients and patients who experienced moderate work stress. Conclusion: Strong synchrony of change exists between depression severity and disability. Perhaps, because of the strength of this synchrony, few contextual characteristics moderated the association. Clinicians should be aware of the risk of slower or incomplete functional recovery in older people and those without a job or those experiencing low work stress.C. E. Significant outcomes• Strong synchrony of change between depression severity and disability was found. That is, reductions in depressive symptoms over time were accompanied by reductions in disability.• However, considerable heterogeneity existed: in some patients, disability did not recover in accordance with their depression severity.• Age and work stress appeared to moderate the synchrony of change between decreasing depression severity and disability, suggesting that the synchrony of change between decreasing depression severity and disability is stronger among patients of lower age and ⁄ or moderate work stress. Limitations• Measures we used were merely self-report, so that we cannot rule out potential bias by misrepresentation of self-reported depression severity and disability.• Analyses were not adjusted for premorbid d...

Course and Risk Factors of Functional Impairment in Subthreshold Depression and Anxiety

“…[27] Still, even if no deterioration is apparent, it would be interesting to observe factors associated with a slower recovery in functioning. For example, although not found in the present sample with subthreshold symptoms, Verboom et al [45] found that among persons recovering from full-syndromal MDD, higher age was associated with a slower recovery in functioning over time.…”

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“…Our results demonstrate strong correlations between (last week) experienced symptom distress and (last month) experienced disability. These results are consistent with research by Verboom et al (2012) andKa (2009) and with the conceptualization of mental disorders in DSM-5 (American Psychiatric Association, 2013). Indeed, the DSM-5 definition of a mental disorder consists of both concepts: clinically significant distress (e.g., painful symptoms) and/or disability (i.e., impairment in one or more important areas of functioning; American Psychiatric Association, 2013).…”

“…The current study has three aims: first, we will investigate the relationship between symptom distress and experienced disability at three measurement points in a two-year period. Based on earlier research (McKnight et al, 2016;Verboom et al, 2012) we expect moderate to strong correlations for this relation. Second, we are interested in the differences in the effects of the symptom reduction and reduction in experienced disability in patients that receive evidence-based psychotherapy for mood and anxiety disorders in routine clinical practice.…”

“…That is, physical health, mental health, and quality of life changed in synchrony with depressive symptoms. Comparably, Verboom et al (2012) | 2447 (r = 0.54) between a decrease in depression severity and reductions in overall disability. Comparably, Brown et al (2015) investigated symptoms and functional impairment in patients with anxiety disorders over a period of 18months, using a cross-lagged panel design.…”

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