A Mutually Reinforcing System? Longitudinal Changes in Psychological Distress, Functional Impairment, and Prescription Medication Consumption Among Adults

Abstract

Depressive and anxiety disorders involve psychological distress that produces functional impairment (e.g., social, occupational). These disorders are frequently comorbid and treated with medication. Randomized controlled trials showed small benefits of medication over pill placebo, whereas medication predicted increasing distress in some community samples. The current analyses clarified longitudinal relations among distress, impairment, and consumption of medication prescribed for distress in national sample of adults. Distress, impairment, and medication predicted increases in one another, forming a “mutually reinforcing system.” For example, adults consuming medication showed increasing distress and impairment. Possible explanations for this finding include medication’s low effectiveness and/or iatrogenic effects (e.g., oppositional tolerance) in longer-term community use. Because medication is often consumed for distress, future research should examine possible risk mechanisms.