Prediction of acute-phase treatment outcomes by adding a single-item measure of activity impairment to symptom measurement: development and validation of an interactive calculator from the STAR*D and CO-MED trials. Jha MK, South C, Trivedi J, Minhajuddin A, Rush AJ, Trivedi MH. The World Health Organization Health and Work Performance Questionnaire (HPQ). ![]() Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, et al. Papers of particular interest, published recently, have been highlighted as: ![]() Our proposed biopsychosocial model of functioning in depression may serve to define an individual’s “functional impairment profile,” which can be used to identify targeted and personalized treatments for depression, and lead to improved outcomes. The implications of these findings on depression treatment strategies are also discussed. The findings from published literature are organized into a proposed working biopsychosocial model of functional impairment in MDD that highlights the strengths and existing research gaps in the field. There is currently a paucity of data regarding neurobiological mechanisms of functional impairment. Furthermore, the most consistent findings point to MDD symptom severity, cognitive deficits, sleep, fatigue, low energy, and social isolation as key contributors to functional outcomes in MDD. Notably, studies consistently demonstrate the divergent trajectories of improvement of depression symptoms and functional impairment. ![]() Despite the prevalence of functional impairment in MDD, it has not typically been investigated as a primary treatment outcome in MDD until recently, as treatment studies have largely focused on symptoms. Major depressive disorder (MDD) is a leading cause of disability and is associated with substantial economic burden, largely due to the functional impairment common among MDD patients. This narrative review summarizes the current evidence regarding functional impairment in MDD and the factors contributing to it.
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