Cited by 2,130Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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The Functioning and Well-being of Depressed Patients: Results From the Medical Outcomes Study

Wells, Kenneth B.·1989·JAMA

DOI 10.1001/jama.1989.03430070062031

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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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Brooks, W. B., Jordan, J. S., Divine, G., Smith, K. S., & Neelon, F. A. (1990) · Medical Care · doi:10.1097/00005650-199009000-00009 · Cited by 82
Effect on disability outcomes of a depression relapse prevention program
Von Korff, M., Katon, W., Rutter, C., Ludman, E., Simon, G., Lin, E., & Bush, T. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000097336.95046.0c · Cited by 81
Longitudinal Associations Between Husbands’ and Wives’ Depressive Symptoms
Kouros, C. D., & Cummings, E. M. (2010) · Journal of Marriage and Family · doi:10.1111/j.1741-3737.2009.00688.x · Cited by 82
“…depressive condition in community samples (e.g., Judd, Akiskal, & Paulus, 1997) and are a risk factor for developing depression (e.g., Beach, Martin, Blum, & Roman, 1993; Broadhead, Blazer, George, & Tse, 1990; Horwath, Johnson, Klerman, & Weissman, 1992; Judd et al., 1998; Wells et al., 1989).”
Background
Care utilization and outcome of DSM‐III‐R major depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)
Spijker, J., Bijl, R. V., de Graaf, R., & Nolen, W. A. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00363.x · Cited by 82
“Depressive disorder is a widespread condition (1, 2) that can cause serious functional impairment and reduced quality of life (3, 4).”
Background
The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus.
Kohen, D., Burgess, A., Catalan, J. M., & Lant, A. F. (1998) · Quality of Life Research · doi:10.1023/a:1024961325084 · Cited by 82
Minor Depression: A Review of the Literature
Beck, D. A., & Koenig, H. G. (1996) · The International Journal of Psychiatry in Medicine · doi:10.2190/ac30-p715-y4td-j7d2 · Cited by 81
Health caring. Psychosocial support for patients with cancer
Spiegel, D. (1994) · Cancer · doi:10.1002/1097-0142(19940815)74:4+ · Cited by 110
Screening for major and minor depression in a multiethnic sample of Asian primary care patients: A comparison of the nine-item Patient Health Questionnaire (PHQ-9) and the 16-item Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR16)
Sung, S. C., Low, C. C. H., Fung, D. S. S., & Chan, Y. H. (2013) · Asia-Pacific Psychiatry · doi:10.1111/appy.12101 · Cited by 82
The association of psychosocial factors and depression with hypertension among older adults
Bosworth, H. B., Bartash, R. M., Olsen, M. K., & Steffens, D. C. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1026 · Cited by 81
“Depressive disorder is also associated with significant functional impairment and substantial increases in health care use (Wells et al., 1989; Johnson et al., 1992).”
Background
Smoking and Health-Related Quality of Life in the General Population. Independent Relationships and Large Differences According to Patterns and Quantity of Smoking and to Gender
Coste, J., Quinquis, L., d’Almeida, S., & Audureau, É. (2014) · PLoS ONE · doi:10.1371/journal.pone.0091562 · Cited by 80
“This association deserves careful attention due to the massive, well-established impact of depression on HRQoL [35,36].”
Background
Depression and Self-Reported Physical Health in Patients With Coronary Disease: Mediating and Moderating Factors
Sullivan, M. D., LaCroix, A. Z., Russo, J. E., & Walker, E. A. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200103000-00008 · Cited by 81
“Of the 34 subjects lost to follow-up during the 5-year follow-up interval (between the 1- and 6-year time points), 21 were ineligible for the following reasons: death (10), dementia (2), critical illness (4), left Group Health Cooperative before completion of the 5-year follow-up period (3), or could not be contacted…”
Background
Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders
Salomonsson, S., Hedman‐Lagerlöf, E., & Öst, L. (2018) · Psychological Medicine · doi:10.1017/s0033291718000065 · Cited by 80
“CMDs lead to a substantial reduction of functioning and quality of life (Wells et al. 1989; Comer et al. 2011), and cause most long-term sick leave of all medical conditions (Henderson et al. 2011).”
Background
Brain networks of happiness: dynamic functional connectivity among the default, cognitive and salience networks relates to subjective well-being
Shi, L., Sun, J., Wu, X., Wei, D., Chen, Q., Yang, W., Chen, H., & Qiu, J. (2018) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsy059 · Cited by 81
“, 2010), such as autism spectrum disorder (ASD) and depression, that exhibit low levels of happiness (Wells et al., 1989; Goodman et al., 2000; Cloninger, 2006).”
Background
Assessment of Differential Item Functioning for Demographic Comparisons in the MOS SF-36 Health Survey
Perkins, A. J., Stump, T. E., Monahan, P. O., & McHorney, C. A. (2006) · Quality of Life Research · doi:10.1007/s11136-005-1551-6 · Cited by 81
Depression Decision Support in Primary Care: A Cluster Randomized Trial
Dobscha, S. K., Corson, K., Hickam, D. H., Perrin, N., Kraemer, D. F., & Gerrity, M. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-7-200610030-00005 · Cited by 79
Validation of the gastrointestinal quality of life index for patients with potentially operable periampullary carcinoma
van Dijkum, E. J. M. N., Terwee, C. B., Oosterveld, P., van der Meulen, J., Gouma, D. J., & de Haes, J. C. J. M. (2000) · British journal of surgery · doi:10.1046/j.1365-2168.2000.01307.x · Cited by 80

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
DOI: 10.1001/jama.1989.03430070062031
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: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology (medical) › 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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The Functioning and Well-being of Depressed Patients: Results From the Medical Outcomes Study

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