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Mental health and well-being in a 6-year follow-up of patients with depression

Assessments of patients and clinicians

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Abstract

Background

Psychiatric patients have the right to strive for well-being and not only be confined to symptom reduction. Studies are needed to assess global well-being during recovery from depression by comparing the assessments of patients and clinicians.

Method

A 6-year natural follow-up of 185 depressive out-patients was carried out with health questionnaires at baseline, 0.5, 1, 2 and 6 years, including scales on depression (BDI, HDRS), general psychopathology (SCL), functional capacity (GAF, SOFAS) and life satisfaction (LS). A structured diagnostic interview was carried out at baseline, 2 and 6 years. Complete follow-up data were obtained from 121 patients.

Results

In general, depressive patients mainly attained a normal mood, adequate functional capacity and life satisfaction. Those with a slow recovery improved with successive treatment contacts, eventually reaching levels of mental health not significantly different from the others. Throughout the follow-up, recovery was similarly shown with the self-reported BDI-21, SCL-90 and LS-4, while intercorrelations between clinician ratings were low at baseline.

Conclusions

Adequate mental health and global well-being can be reached among depressive patients, but it may take time in treatment. Subjective assessments are reliable. The 4-item life satisfaction scale is a global well-being indicator and a valid treatment outcome measure.

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References

  1. Adler DA, McLaughin TJ, Rogers WH, Chang H, Lapitsky L, Lerner D (2006) Job performance deficient due to depression. Am J Psychiatry 163:1569–1576

    Article  PubMed  Google Scholar 

  2. Andrews FM, Withey SB (1976) Social indicators of well-being: American perceptions of life quality. Plenum, New York

    Google Scholar 

  3. Aigner M, Förster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M (2006) What does the WHOQOL-Bref measure? Measurement overlap between quality of life and depressive symptomology in chronic somatoform pain disorder. Soc Psychiatry Psychiatr Epidemiol 41:81–86

    Article  PubMed  Google Scholar 

  4. Allardt E (1973) About dimension of welfare: an explanatory analysis of the comparative Scandinavian survey. University of Helsinki, Research group of comparative sociology. Research reports: 1

  5. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th eds. Text version-DSM-IV-TR, Washington, DC

  6. Appelberg K, Romanov K, Honkasalo ML, Koskenvuo M (1991) Interpersonal conflicts at work and psychosocial characteristics of employees. Soc Sci Med 32:1051–1056

    Article  PubMed  CAS  Google Scholar 

  7. Arroll B, Goodyear-Smith F, Kerse N, Fishman T, Gunn J (2005) Effect of the addition of a “help” question to two screening questions on specificity for diagnosis of depression in general practice: a diagnostic validity study. BMJ 331:884

    Article  PubMed  CAS  Google Scholar 

  8. Arroll B, Khin N, Kerse N (2003) Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ 327:1144–1146

    Article  PubMed  Google Scholar 

  9. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  10. Bray I, Gunnell D (2006) Suicide rates, life satisfaction and happiness as markers for population mental health. Soc Psychiatry Psychiatr Epidemiol 41:333–337

    Article  PubMed  Google Scholar 

  11. Brodaty H, Luscombe G, Peisah C, Anstey K, Andrews G (2001) A 25-year longitudinal, comparison study of the outcome of depression. Psychol Med 31:1347–1359

    Article  PubMed  CAS  Google Scholar 

  12. Cohen S, Pressman SD (2006) Positive affect and health. Curr Dir Psychol Sci 15:122–125

    Article  Google Scholar 

  13. Cuijpers P, Smit F (2002) Excess mortality in depression: a meta-analysis of community studies. J Affect Disord 72:227–236

    Article  PubMed  Google Scholar 

  14. Dear K, Henderson S, Korten A (2002) Well-being in Australia. Soc Psychiatry Psychiatr Epidemiol 37:503–509

    Article  PubMed  Google Scholar 

  15. Derogatis LR, Lipman RS, Covi L (1973) SCL-90: an outpatient psychiatric rating scale—preliminary report. Psychopharmacol Bull 9:13–28

    PubMed  CAS  Google Scholar 

  16. Goldney RD, Fisher LJ, Dal Grande E, Taylor AW (2004) Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population. Soc Psychiatry Psychiatr Epiodemiol 39:293–298

    Article  Google Scholar 

  17. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    PubMed  CAS  Google Scholar 

  18. Hanson L (2006) Determinants of quality of life in people with severe mental illness. Acta Psychiatr Scand 113(suppl.429): 46–50

    Article  Google Scholar 

  19. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K (1995) Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 52:11–19

    PubMed  CAS  Google Scholar 

  20. Holi MM, Sammallahti PR, Aalberg VA (1998) A Finnish validation study of the SCL-90. Acta Psychiatr Scand 97:42–46

    Article  PubMed  CAS  Google Scholar 

  21. Huffman JC, Smith FA, Blais MA, Beiser ME, Januzzi JL, Fricchione GL (2006) Rapid screening for major depression in post-myocardial infarction patients: an investigation using beck depression inventory II items. Heart 92:1656–1660

    Article  PubMed  CAS  Google Scholar 

  22. Jahoda M (1958) Current concepts of positive mental health. Basic, New York

    Google Scholar 

  23. Judd LL, Akiskal HS, Maser JD, Zeller PJ, Endicott J, Coryell W, Paulus MP, Kunovac JL, Leon AC, Mueller TI, Rice JA, Keller MB (1998) A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry 55:694–700

    Article  PubMed  CAS  Google Scholar 

  24. Judd LL, Akiskal HS, Zeller PJ, Paulus M, Leon AC, Maser JD, Endicott J, Coryell W, Kunovac JL, Mueller TI, Rice JP, Keller MB (2000) Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry 57:375–380

    Article  PubMed  CAS  Google Scholar 

  25. Judd LL, Paulus MJ, Schettler PJ, Akiskal HS, Endicott J, Leon AC, Maser JD, Mueller T, Solomon DA, Keller MB (2000) Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness? Am J Psychiatry 157:1501–1504

    Article  PubMed  CAS  Google Scholar 

  26. Kaprio J, Sarna S, Koskenvuo M, Rantasalo I (1978) The Finnish twin registry: formation and compilation, questionnaire study, zygosity determination procedures, and research program. Prog Clin Biol Res 24(Pt B):179–184

    PubMed  Google Scholar 

  27. Katschnig H, Krautgartner M, Schrank B, Angermeyer MC (2006) Quality of life in depression. In: Katschnig H, Freeman H, Sartorius N. (eds) Quality of life in mental disorders, 2nd edn, Wiley, San Francisco, p. 129–140

  28. Kazis LE, Anderson JJ, Meenen RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189

    Article  PubMed  CAS  Google Scholar 

  29. Kennedy N, Abbott R, Paykel ES (2003) Remission and recurrence of depression in the maintenance era: long-term outcome in a Cambridge cohort. Psychol Med 33:827–838

    Article  PubMed  CAS  Google Scholar 

  30. Kessing LV (2007) Epidemiology of subtypes of depression. Acta Psychiatr Scand 115(suppl 433):85–89

    Google Scholar 

  31. Klein DN, Schwartz JE, Rose S, Leader JB (2000) Five-year course and outcome of dysthymic disorder: a prospective, naturalistic follow-up study. Am J Psychiatry 157:931–939

    Article  PubMed  CAS  Google Scholar 

  32. Klein DN, Shankman SA, Roze S (2006) Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression. Am J Psychiatry 163:872–880

    Article  PubMed  Google Scholar 

  33. Koivumaa-Honkanen H (1998) Life satisfaction as a health predictor. Kuopio University Publications D. Medical Sciences 143. Kuopio

  34. Koivumaa-Honkanen H, Honkanen R, Antikainen R, Hintikka J, Laukkanen E, Honkalampi K, Viinamäki H (2001) Self- reported life satisfaction and recovery from depression in a 1-year prospective study. Acta Psychiatr Scand 103:38–44

    Article  PubMed  CAS  Google Scholar 

  35. Koivumaa-Honkanen H, Honkanen R, Koskenvuo M, Viinamäki H, Kaprio J (2002) Life dissatisfaction as a predictor of fatal injuries in 20-year follow-up. Acta Psychiatr Scand 105:444–450

    Article  PubMed  CAS  Google Scholar 

  36. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2000) Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. Am J Epidemiol 152:983–991

    Article  PubMed  CAS  Google Scholar 

  37. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2001) Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 158:433–439

    Article  PubMed  CAS  Google Scholar 

  38. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2004) Life satisfaction and depression in a 15-year follow-up of healthy adults. Soc Psychiatry Psychiatr Epidemiol 39:994–999

    Article  Google Scholar 

  39. Koivumaa-Honkanen H, Kaprio J, Honkanen RJ, Viinamäki H, Koskenvuo M (2005) The stability of life satisfaction in a 15-year follow-up adult Finns healthy at baseline. BMC Psychiatry 18;5:4.

    Google Scholar 

  40. Koivumaa-Honkanen H, Koskenvuo M, Honkanen R, Viinamäki Heikkilā K, Kaprio J (2004) Life dissatisfaction and subsequent work disability pension in an 11-year follow-up. Psychol Med 34:221–228

    Article  PubMed  CAS  Google Scholar 

  41. Koivumaa-Honkanen HT, Viinamäki H, Honkanen R, Tanskanen A, Antikainen R, Niskanen L, Jääskeläinen J, Lehtonen J (1996) Correlates of life satisfaction among psychiatric patients. Acta Psychiatr Scand 94:372–378

    Article  PubMed  CAS  Google Scholar 

  42. Koskenvuo M, Langinvainio H, Kaprio J, Rantasalo I, Sarna S (1979) The Finnish twin registry: baseline characteristics. Section III. Occupational and psychosocial factors. Public Health Publications M49. Department of Public Health, University of Helsinki, Helsinki

  43. Lasalvia A, Bonetto C, Malchiodi F, Salvi G, Parabiaghi A, Tansella M, Ruggeri M (2005) Listening patients’ needs to improve their subjective quality of life. Psychol Med 35:1655–1665

    Article  PubMed  Google Scholar 

  44. Lasalvia A, Ruggeri M, Santolini N (2002) Subjective quality of life: its relationship with clinician-rated and patient-rated psychopathology. Psychother Psychosom 71:275–284

    Article  PubMed  Google Scholar 

  45. Lyubomirsky S, King L, Diener E (2005) The benefits of frequent positive affect: does happiness lead to success. Psychol Bull 131:803–855

    Article  PubMed  Google Scholar 

  46. Meyer C, Rumpf HJ, Hapke U, John U (2004) Impact of psychiatric disorders in the general population: satisfaction with life and the influence of comorbidity and disorder duration. Soc Psychiatry Psychiatr Epidemiol 39:435–441

    Article  PubMed  Google Scholar 

  47. Michaud CM, Murray CJL, Bloom BR (2001) Burden of disease—implications for future research. JAMA 285:535–539

    Article  PubMed  CAS  Google Scholar 

  48. Mintz J, Mintz LI, Arruda MJ, Hwang SS (1992) Treatments of depression and functional capacity to work. Arch Gen Psychiatry 49:761–768

    PubMed  CAS  Google Scholar 

  49. Montgomery SA, Åsberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389

    Article  PubMed  CAS  Google Scholar 

  50. Mueller TI, Leon AC, Keller MB, Solomon DA, Endicott J, Coryell W, Warshaw M, Maser JD (1999) Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. Am J Psychiatry 156:1000–1006

    PubMed  CAS  Google Scholar 

  51. Möller H-J, Bottlender R (2006) Severe mental illness in depression. Acta Psychiatr Scand 113(suppl 429):64–68

    Article  Google Scholar 

  52. Ruggeri M, Bisoffi G, Fontecedro L, Warner R (2001) Subjective and objective dimensions of quality of life in psychiatric patients: a factor analytical approach. Br J Psychiatry 178:268–275

    Article  PubMed  CAS  Google Scholar 

  53. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrrath PJ, Rosenbaum JF (2006) Acute and long-term outcomes in depressed out-patients requiring one or several treatment steps: a star*D report. Am J Psychiatry 163: 1905–1917

    Article  PubMed  Google Scholar 

  54. Rutz W (2006) Social psychiatry and public mental health: present situation and future objectives. Time for rethinking and renaissance? Acta Psychiatr Scand (Suppl 429):95–100

    Article  PubMed  Google Scholar 

  55. Schomerus G, Matschinger H, Angermeyer MC (2006) Preferences of the public regarding cutbacks in expenditure for patient care. Sos Psychiatry Psychiatr Epidemiol 41:369–377

    Article  Google Scholar 

  56. Solomon DA, Keller MB, Leon AC, Mueller TI, Lavori PW, Shea MT, Coryell W, Warshaw M, Turvey C, Maser JD, Endicott J (2000) Multiple recurrences of major depressive disorder. Am J Psychiatry 157:229–233

    Article  PubMed  CAS  Google Scholar 

  57. Sorvaniemi M, Helenius H, Salokangas RKR (1998) Improved pharmacotherapy of major depression in psychiatric outpatients care. Nord J Psychiatry 52:155–161

    Article  Google Scholar 

  58. Spitzer RL, Gibbon M, Williams JWB, Endicott J (1966) Global assessment of functioning (GAF) scale. In: Sederer LI, Dickey B, (eds). Outcome assessment in clinical practice. Williams and Wilkins, Baltimore

    Google Scholar 

  59. Spitzer RL, Williams JB, Gibbon M, First MB (1992) The structured clinical interview for DSM-III-R (SCID) I: history, rationale and description. Arch Gen Psychiatry 49:624–629

    PubMed  CAS  Google Scholar 

  60. Vaillant GE (2003) Mental health. Am J Psychiatry 160: 1373–1384

    Article  PubMed  Google Scholar 

  61. Viinamäki H, Haatainen K, Honkalampi K, Tanskanen A, Koivumaa-Honkanen H, Antikainen R, Valkonen-Korhonen M, Hintikka J (2006) Which factors are important predictors of non-recovery from major depression? A 2-year prospective observational study. Nord J Psychiatry 60:410–416

    Article  PubMed  Google Scholar 

  62. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:603–613

    Article  PubMed  Google Scholar 

  63. Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Twelve-month use of mental health services in the United States. Arch Gen Psychiatry 62:629–640

    Article  PubMed  Google Scholar 

  64. Wells KB, Burnam MA, Rogers W, Hays R, Camp P (1992) The course of depression in adult outpatients. Results from the medical outcome study. Arch Gen Psychiatry 49:788–794

    PubMed  CAS  Google Scholar 

  65. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients. Results from the medical outcomes study. JAMA 262:914–919

    Article  PubMed  CAS  Google Scholar 

  66. Wittchen HU, Jacobi F (2005) Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 15:357–376

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This study was supported by the Academy of Finland (grant 116996).

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Authors and Affiliations

  1. Dept. of Psychiatry, University of Oulu, Oulu, Finland

    Heli Koivumaa-Honkanen MD, PhD, MPH

  2. Dept. of Psychiatry, Lapland Hospital District, Muurola, Finland

    Heli Koivumaa-Honkanen MD, PhD, MPH

  3. Dept. of Psychiatry, 4977, Kuopio University Hospital, P.O.B. 1777, 70211, Kuopio, Finland

    Heli Koivumaa-Honkanen MD, PhD, MPH, Kirsi Honkalampi PhD, Risto Antikainen PhD, Jukka Hintikka MD, PhD, Kaisa Haatainen PhD & Heimo Viinamäki MD, PhD

  4. Dept. of Psychiatry, University of Kuopio, Kuopio, Finland

    Timo K. Tuovinen MD & Heimo Viinamäki MD, PhD

  5. Dept. of Psychiatry, Päijät-Häme Central Hospital, Lahti, Finland

    Jukka Hintikka MD, PhD

  6. Dept. of Psychiatry, University of Tampere, Tampere, Finland

    Jukka Hintikka MD, PhD

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  1. Heli Koivumaa-Honkanen MD, PhD, MPH
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  2. Timo K. Tuovinen MD
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  3. Kirsi Honkalampi PhD
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  7. Heimo Viinamäki MD, PhD
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Correspondence to Heli Koivumaa-Honkanen MD, PhD, MPH.

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Koivumaa-Honkanen, H., Tuovinen, T.K., Honkalampi, K. et al. Mental health and well-being in a 6-year follow-up of patients with depression. Soc Psychiat Epidemiol 43, 688–696 (2008). https://doi.org/10.1007/s00127-008-0353-x

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  • DOI: https://doi.org/10.1007/s00127-008-0353-x

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