A Follow - Up Study On Psychosocial Function Of Patients With Severe Depressive Disorder After "clinical Cure"

Major depressive disorder (MDD) is a mental illness that is characterized by high prevalence, high suicide rate, high recurrence rate and high burden. The treatment and rehabilitation of MDD have drawn high attention all over the world. The goal of treatment is to get remission, the psychosocial functioning of the patients who have remitted might have not fully recovered. The psychosocial functioning impairment after remission from major depressive episode is caused by residual symptoms and the continuation of pre-morbid impairments in psychosocial functioning. The improvement of psychosocial functioning lagged behind remission of symptoms. The psychosocial functioning impairment after remission strongly predicted later relapse or recurrence.Our study assessed the psychosocial functioning and the influencing factors in the patients who have achieved remission by setting a longitudinal study. At the same time, our study examined whether adding cognitive behavioral therapy (CBT) to medication would improve both of depressive symptoms and psychosocial functioning by setting a control group. We rated psychosocial functioning by the proper scales at baseline (T1), termination of CBT treatment (T2), and6-month follow-up (T3). We analyzed data using repeated measures ANCOVA, two independent-samples nonparametric test, two independent-samples T test and correlation analysis. All analyses were conducted on intent-to-treat (ITT) sample and all statistical tests were two-tailed, with an alpha level of0.05. All data were examined using SPSS16.0for Windows.The results are as follows:(1)The dimension of physical functioning has no significant change over time, this functioning may have recovered. There are significant differences between two groups on sexual function. The CBT group has worse function than the control group during entire study.(2)The dimension of psychological functioning has no significant change over time, the functioning may have not recovered.(3)The dimension of social functioning has significant change over time in the CBT group, but the control group has not. There are no significant differences between groups. The leisure factor and the overall assessment of quality of life have significant change over time, but the control group has not. There are no significant differences between groups.(4)Automatic thoughts, depressive symptoms and positive coping style have decreased significantly over time, the subjective support and utilization of support have increased over time, but the control group have not. There are no significant differences between groups.(5)CBT with medication may significantly improve the social functioning of MDD patients after remission by reducing the depressive symptoms, reducing the number of automatic thoughts, improving subjective support and utilization of support and taking a more appropriate coping style.