The Importance of Functional Impairment to Mental Health Outcomes: a Case for Reassessing Our Goals in Depression Treatment Research

Overview

Journal Clin Psychol Rev

Specialty Psychology

Date 2009 Mar 10

PMID 19269076

Citations 125

Authors

Patrick E McKnight

Todd B Kashdan

Affiliations

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Abstract

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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