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Cited by 81Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Effect on disability outcomes of a depression relapse prevention program

Von Korff, Michael, Katon, Wayne, Rutter, Carolyn, Ludman, Evette, Simon, Greg, Lin, Elizabeth, Bush, Terry·2003·Psychosomatic Medicine
DOI 10.1097/01.psy.0000097336.95046.0c
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Abstract

OBJECTIVE: This report evaluates the effects of a depression relapse prevention program on disability outcomes among patients treated for depression at high risk for relapse. MATERIALS AND METHODS: Primary care patients initiating antidepressant treatment for depression were assessed 6 to 8 weeks after the initial prescription. Patients responding to initial treatment but at high risk for relapse were randomized to usual care or a relapse prevention intervention (N= 386). The 12-month relapse prevention program included systematic patient education, two psycho-educational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and ongoing monitoring of medication adherence and depressive symptoms via telephone and mail. Disability outcomes were assessed via blinded telephone assessments at 3, 6, 9, and 12 months using SF-36 and Sheehan Disability scales. RESULTS: Usual care patients and relapse prevention program patients had high rates of use of maintenance pharmacotherapy. Both relapse prevention and usual care patients showed improved functioning over the 12-month follow-up period. One of the three disability measures (the SF-36 Social Function scale) showed a significant intervention effect because of continuing improvement at 9 and 12 month follow-up, whereas the Sheehan Disability Scale showed a nonsignificant trend toward greater improvements in disability among relapse prevention patients than among usual care controls. CONCLUSIONS: Moderate effects of a relapse prevention intervention on depressive symptoms were associated with modest and variable effects on disability outcomes. Inconsistent effects of the intervention for disability outcomes may be because of the high rates of maintenance pharmacotherapy among usual care patients, relatively mild levels of depressive symptoms among both intervention and control patients at baseline, the absence of a specific relapse prevention effect of the intervention, and the resultant modest differences in depressive symptoms between intervention and control patients in this trial.

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  • Depression predicts fatigue, shortness of breath, and disability in patients with heart disease or COPD, even after adjusting for severity of illness.

    “Depression has been found to predict fatigue, shortness of breath, and disability in patients with heart disease or COPD, even after adjusting for severity of illness.52–56”

    From Anxiety and Depression in COPD (2008) · cites this paper as [56]

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Authors
Von Korff, M., Katon, W., Rutter, C., Ludman, E., Simon, G., Lin, E., & Bush, T.
Affiliations
Group Health Cooperative (US)
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-11
Volume
65
Issue
6
Pages
938-943
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/01.psy.0000097336.95046.0c
OpenAlex
W2019301116
Cited by
81
References
31
Citations by year
2025: 2 · 2023: 1 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 7 · 2013: 8 · 2012: 9
FWCI
1.29
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH041739, MH4-1739)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression relapse prevention, disability outcome, depression, maintenance pharmacotherapy, shared decision-making, patient education, psychoeducational intervention, medication adherence, telephone monitoring, primary care, antidepressant treatment, social functioning, SF-36, Sheehan Disability Scale
MeSH terms
Adult, Antidepressive Agents, Depression, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Postal Service, Recurrence, Severity of Illness Index, Social Behavior, Telephone, Single-Blind Method, Treatment Outcome

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