Mediators of the association between depression and role functioning

Objective:  While the adverse effect of Major Depressive Episode on role functioning is well established, the exact pathways remain unclear. Method:  Data from The European Study of the Epidemiology of Mental Disorders, a cross‐sectional survey including 21 425 adults from six European countries, we...

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Bibliographic Details
Published in:Acta Psychiatrica Scandinavica 2008-12, Vol.118 (6), p.451-458
Main Authors: Buist-Bouwman, M. A., Ormel, J., De Graaf, R., De Jonge, P., Van Sonderen, E., Alonso, J., Bruffaerts, R., Vollebergh, W. A. M.
Format: Article
Language:English
Subjects:
Activities of Daily Living - classification
Adaptation, Psychological
Adolescent
Adult
Adult and adolescent clinical studies
Aged
Biological and medical sciences
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Cognition Disorders - psychology
Cost of Illness
Cross-Sectional Studies
Depression
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - psychology
Depressió psíquica
Disability
Disability Evaluation
Efficiency
Epidemiology
Europe
functional limitations
general population
Health Surveys
Humans
Medical sciences
Mental depression
Middle Aged
Models, Psychological
Mood disorders
Motivation
Personality Assessment
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Role
role functioning
Shame
Social Environment
Young Adult
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Summary:Objective:  While the adverse effect of Major Depressive Episode on role functioning is well established, the exact pathways remain unclear. Method:  Data from The European Study of the Epidemiology of Mental Disorders, a cross‐sectional survey including 21 425 adults from six European countries, were used to assess 12‐month depression (Composite International Diagnostic Interview), activity limitations and role functioning in the past 30 days (Disability Assessment Schedule). An a priori model based on the World Health Organization’s International Classification of Functioning, Disability and Health was designed and a structural equation model for categorical and ordinal data was used (MPlus) to estimate the extent to which six limitations mediated the association between depression and role functioning. Results:  The unadjusted association between depression and role functioning was strong (0.43; SE = 0.04). In the best‐fitting model, only concentration and attention problems and embarrassment mediated a significant amount of association (direct effect dropped to 0.17; SE = 0.10, which was no longer significant). Conclusions:  Targeting cognition and embarrassment in treatment could help reduce depression‐associated role disfunctioning.
ISSN:0001-690X
1600-0447
0065-1591
DOI:10.1111/j.1600-0447.2008.01285.x