The DOI matches its Crossref record; 228 of the 228 references it cites were found in a registry or an index.
The importance of functional impairment to mental health outcomes: A case for reassessing our goals in depression treatment research
Open accessAbstract
Outcomes in depression treatment research include both changes in symptom severity and functional impairment. Symptom measures tend to be the standard outcome but we argue that there are benefits to considering functional outcomes. An exhaustive literature review shows that the relationship between symptoms and functioning remains unexpectedly weak and often bidirectional. Changes in functioning often lag symptom changes. As a result, functional outcomes might offer depression researchers more critical feedback and better guidance when studying depression treatment outcomes. The paper presents a case for the necessity of both functional and symptom outcomes in depression treatment research by addressing three aims-1) review the research relating symptoms and functioning, 2) provide a rationale for measuring both outcomes, and 3) discuss potential artifacts in measuring functional outcomes. The three aims are supported by an empirical review of the treatment outcome and epidemiological literatures.
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In the citing paper
“Moreover, the available literature differed vastly in sampling methods and survey instruments hence capturing different conceptualisations of severity with no general consensus in distinguishing between mild, moderate, and severe states of MDD [41].”
From Burden of depressive disorders by country, sex, age, and year: findings from the Global Burden of Disease Study 2010 (2013) · cites this paper as [41]
In the citing paper
“First-line psychosocial treatments produce modest improvements in social functioning – falling short of much larger changes observed for symptoms,(4–6) with social disconnection persisting after symptoms remit.(1)”
In the citing paper
“which may explain in part why social impairments persist following established treatments.(4, 5)”
In the citing paper
“improvements in positive affect and well-being tend to be smaller and lag behind reductions in clinical symptoms following established treatments.(4, 5, 34)”
In the citing paper
“Contemporary treatments for anxiety and depression improve facets of social connectedness; however, improvements tend to be modest and do not match the much larger changes typically observed for symptoms (Eng, Coles, Heimberg, & Safren, 2005; Hofmann, Wu, & Boettcher, 2014; McKnight & Kashdan, 2009).”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as McKnight & Kashdan, 2009
In the citing paper
“Because social disconnection is common across a wide range of psychiatric conditions and existing treatments leave room for improvement for many patients in this domain (Hofmann et al., 2014; McKnight & Kashdan, 2009)”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as McKnight & Kashdan, 2009
In the citing paper
“Because social disconnection is common across a wide range of psychiatric conditions and existing treatments leave room for improvement for many patients in this domain (Hofmann et al., 2014; McKnight & Kashdan, 2009)”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as McKnight & Kashdan, 2009
In the citing paper
“since the presence of unresolved mental health symptoms can limit improvements in other domains [96, 97].”
From Patient-reported outcome measures for life engagement in mental health: a systematic review (2022) · cites this paper as [96]
In the citing paper
“improvement in functional outcomes that reflect life engagement may lag behind symptomatic improvement”
From Patient-reported outcome measures for life engagement in mental health: a systematic review (2022) · cites this paper as [96]
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Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
(1992) · PubMed · Cited by 33,716
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962
Kessler, R. C. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010008002 · Cited by 12,370
Flagged first, then by citations
Research works printed but not linked: 2
- Kramer, 2004, Major depressive disorder: Assessing the spectrum of symptoms and functional impairment at treatment entry and follow-up, Vol. 3, 293
- Paykel, 1999, Social functioning and the depressed patient, International Journal of Psychiatry in Clinical Practice, 3, S9
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Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., Vos, T., & Whiteford, H. A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001547 · Cited by 3,115
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,181
The Impact of Individual Depressive Symptoms on Impairment of Psychosocial Functioning
Fried, E. I., & Nesse, R. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0090311 · Cited by 467
Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice.
Ruggero, C. J., Kotov, R., Hopwood, C. J., First, M., Clark, L. A., Skodol, A. E., Mullins-Sweatt, S. N., Patrick, C. J., Bach, B., Cicero, D. C., et al. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000452 · Cited by 333
Spielmans, G. I., Berman, M. I., Linardatos, E., Rosenlicht, N. Z., Perry, A., & Tsai, A. C. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001403 · Cited by 275
Metadata
- Authors
- McKnight, P. E., & Kashdan, T. B.
- Affiliations
- George Mason University (US)
- Corresponding author
- McKnight, Patrick E.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 29
- Issue
- 3
- Pages
- 243-259
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC2814224
- OpenAlex
- W1971568036
- Cited by
- 400
- References
- 223
- Citations by year
- 2026: 30 · 2025: 29 · 2024: 27 · 2023: 19 · 2022: 43 · 2021: 34 · 2020: 31 · 2019: 31 · 2018: 19 · 2017: 24 · 2016: 30 · 2015: 25 · 2014: 18 · 2013: 20 · 2012: 6
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R21MH073937, MH-73937)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR047595)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- depression, functional disability, mental health outcomes, symptom severity, treatment outcome measures, measurement artifacts
- MeSH terms
- Depressive Disorder, Major, Major Depressive Disorder, Employment, Feedback, Goals, Health Status, Humans, Psychology, Research, Social Behavior
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