TY  - JOUR
T1  - PSychosocial disability during the long-term course of unipolar major depressive disorder
AU  - Judd LL, Akiskal HS, Zeller PJ, et al
Y1  - 2000/04/01
N1  - 10.1001/archpsyc.57.4.375
JO  - Archives of General Psychiatry
SP  - 375
EP  - 380
VL  - 57
IS  - 4
N2  - Background 
    The goal of this study was to investigate psychosocial disability in relation to depressive symptom severity during the long-term course of unipolar major depressive disorder (MDD).Methods 
    Monthly ratings of impairment in major life functions and social relationships were obtained during an average of 10 years' systematic follow-up of 371 patients with unipolar MDD in the National Institute of Mental Health Collaborative Depression Study. Random regression models were used to examine variations in psychosocial functioning associated with 3 levels of depressive symptom severity and the asymptomatic status.Results 
    A progressive gradient of psychosocial impairment was associated with a parallel gradient in the level of depressive symptom severity, which ranges from asymptomatic to subthreshold depressive symptoms to symptoms at the minor depression/dysthymia level to symptoms at the MDD level. Significant increases in disability occurred with each stepwise increment in depressive symptom severity.Conclusions 
    During the long-term course, disability is pervasive and chronic but disappears when patients become asymptomatic. Depressive symptoms at levels of subthreshold depressive symptoms, minor depression/dysthymia, and MDD represent a continuum of depressive symptom severity in unipolar MDD, each level of which is associated with a significant stepwise increment in psychosocial disability.
SN  - 0003-990X
M3  - doi: 10.1001/archpsyc.57.4.375
UR  - http://dx.doi.org/10.1001/archpsyc.57.4.375
ER  -