The Functioning and Well-being of Depressed Patients

TLDR

The study compares functioning and well‑being of depressed patients to those with chronic medical conditions and to healthy controls. Data were drawn from 11,242 outpatients across three U.S. health care systems. Depressed patients showed markedly poorer physical, social, and role functioning, worse perceived health, and greater bodily pain than non‑chronic patients, with these deficits comparable to or exceeding those associated with major chronic illnesses such as hypertension, diabetes, and arthritis, and depression and chronic conditions produced additive adverse effects on functioning.

Abstract

We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11 242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning. (<i>JAMA</i>. 1989;262:914-919)