The Functioning and Well-being of Depressed Patients: Results From the Medical Outcomes Study
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. (JAMA. 1989;262:914-919)
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When present alone, depression was found to be as debilitating an illness as a chronic somatic illness.
“When present alone, depression was found to be as debilitating an illness as a chronic somatic illness [28].”
From Treatment of somatization in primary care (1997) · cites this paper as [28]
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“…imposes significant costs on society (Brunello et al. 1995; Thase 2001; Fava et al. 2003a; Greenberg et al. 2003; McIntyre and O’Donovan 2004), even more so when not properly diagnosed or undertreated (Wells et al. 1989a; Üstün and Sartorius 1995; Unützer et al. 2000b, Young et al. 2001).”
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“In general, depression and anxiety may substantially reduce a person’s quality of life and that of his or her family (26, 27).”
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“Depression is known to have a profound adverse influence on quality of life and overall functioning (3-5).”
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“It is associated with considerable morbidity (7-9), excess mortality from suicide and other causes (10-13), and substantial direct and indirect costs (14).”
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“…depression, anxiety, pain) produce so much disability and loss of well-being (Ormel et al., 1993; Ormel et al., 1994; Von Korff et al., 1992; Wells et al., 1989) may be because those impairments cause decrements in higher-order mental capacities such as energy, self-regulation of affect,…”
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“In the Medical Outcomes Study it was shown that impairment of well-being and functioning, uniquely associated with depression, was com- 1397 parable or worse than that uniquely associated with major chronic medical conditions (Wells et al. 1989; Hays et al. 1995).”
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“These scores were then compared with published scores from a general outpatient clinic sample (6) and with scores from ambulatory patients with chronic medical conditions (12, 13).”
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“This instrument has excellent reliability and validity and has been used to evaluate functional status in depressed, chronically ill, and healthy populations (Wells et al., 1989).”
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- Authors
- Wells, K. B.
- Corresponding author
- Wells, Kenneth B.
- ORCID
- Wells, Kenneth B.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1989-08-18
- Volume
- 262
- Issue
- 7
- Pages
- 914
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1539382539
- Cited by
- 2,130
- References
- 0
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 18 · 2023: 18 · 2022: 21 · 2021: 39 · 2020: 30 · 2019: 33 · 2018: 31 · 2017: 30 · 2016: 25 · 2015: 44 · 2014: 44 · 2013: 61 · 2012: 49
- FWCI
- 66.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Funders
- National Institute of Mental Health (MH 42229-03S1)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, depressive symptoms, chronic disease, functional status, well-being, physical function, social functioning, role functioning, health perception, bodily pain, outpatients, comorbidities
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