10-year course of social adjustment in major depression

Abstract

Background: It is now widely acknowledged that depression is accompanied by major deficits in social functioning. However, the course of this dysfunction and its relationship with depressive symptoms in the long term is less understood. Methods: The Group for Longitudinal Affective Disorders Study (GLADS) in Japan has conducted a 10-year prospective, serial follow-up of a cohort of mood disorder patients starting treatment for their index episode. The vicissitudes of the social adjustment of patients with major depression were analyzed using the standardized instrument (Social Adjustment Scale — Self-Report) and in conjunction with the measurement of depressive severity (Centre for Epidemiologic Studies Depression). Results: The results showed: (i) psychiatric patients with major depression commencing treatment showed moderate to extremely large social dysfunction at baseline; (ii) this dysfunction declined rapidly in the first six months of treatment but then levelled off and showed fluctuating patterns up to 10 years of follow-up; (iii) the degree of dysfunction varied from domain to domain, most notable in Work and least notable in Economy subscales; and (iv) the influence of persistent depression also varied from domain to domain, stronger in Housework and Leisure and weakest in Work spheres. Conclusion: Future studies of social functioning in depression need to differentiate its various aspects.