Functional versus syndromal recovery in patients with major depressive disorder and bipolar disorder.

摘要: OBJECTIVE: Many patients with major depressive disorder (MDD) or bipolar (BD) experience impairments in daily life. We investigated whether single-episode MDD (MDD-s), recurrent (MDD-r), and BD differ functional impairments, time since last episode (syndromal state, 4 categories) contributes to impairment, this association is moderated by diagnosis, the role of symptoms. METHOD: Data were derived from 1,664 participants Netherlands Study Depression Anxiety (MDD-s, n = 483; MDD-r, 1,063; BD, 118), 2006 into 2009. In additional analyses, 530 healthy controls included. DSM-IV-TR diagnosis information about syndromal state based on Composite International Diagnostic Interview. Psychosocial impairment was assessed World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Adjusted associations between depression severity investigated. RESULTS: Syndromal not being taken account, experienced more than MDD-s all diagnostic groups, decreased increasing episode. However, impact functioning showed a different course groups (mean [SD] WHODAS score: current: 30.8 [2.8], MDD-r 32.7 [0.9], 37.7 [2.1], P .07; recently remitted: 21.7 [3.5], 24.0 [1.2], 22.1[3.2], .7; 10.6 [3.7], 21.6 [1.4], 19.2 [4.4], .02; remitted > 1 year: 13.3 [0.6], 14.7 [0.5], 17.1 [2.2], .8). accounted for these differences. Moreover, remained impaired when compared that controls. CONCLUSION: Functional recovery may take up year after remission disorder, mainly due residual symptoms, emphasizing need prolonged continuation treatment.