The role of depression course on life functioning and coping outcomes from baseline through 23-year follow-up

Abstract

Background

Although studies have examined how depressed patients’ baseline characteristics predict depression course, still needed are studies of how depression course is associated with modifiable long-term outcomes.

Aims

This study examined six outcomes of three groups representing distinct depression courses (low baseline severity, rapid decline; moderate baseline severity, rapid decline; and high baseline severity, slow decline): medical functioning, coping patterns, family functioning, social functioning, employment, and work functioning.

Method

Adults with depression at baseline (N = 382; 56% women) were followed for 23 years on self-reported outcomes (79% response rate). Data from the baseline assessment and follow-ups (1, 4, 10, and 23 years) were used in a longitudinal analysis to examine associations between depression course and outcomes.

Results

All depression course groups declined on medical and social functioning and employment over follow-up. The high- and moderate-severity depression course groups reported poorer coping patterns than the low-severity group. The high-severity depression course group reported poorer family functioning than the moderate-severity group, and had the poorest work functioning outcome, followed by the moderate-severity and then the low-severity groups.

Conclusions

Patients with a high- or moderate-severity depression course may benefit from treatment that manages coping patterns and improves family and work functioning.

Keywords:

• Depression course
• treatment
• functioning
• medical
• coping
• mental health

Ethical approval

Ethical approval was obtained from the Administrative Panel on Human Subjects in Non-Medical Research at Stanford University (reference #14145).

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This work was supported by the Department of Veterans Affairs, Health Services Research and Development Service [RCS 00-001, CDA 13-279], and NIH NIAAA [AA002863, AA006699, AA012718]; and Eli Lilly and Company.