PMID- 29637391 OWN - NLM STAT- MEDLINE DCOM- 20190918 LR - 20190918 IS - 1573-2649 (Electronic) IS - 0962-9343 (Linking) VI - 27 IP - 8 DP - 2018 Aug TI - Change in functioning outcomes as a predictor of the course of depression: a 12-month longitudinal study. PG - 2045-2056 LID - 10.1007/s11136-018-1853-0 [doi] AB - PURPOSE: Functioning is a necessary diagnostic criterion for depression, and thus routinely assessed in depressive patients. While it is highly informative of disorder severity, its change has not been tested for prognostic purposes. Our study aimed to analyze to what extent early functioning changes predict depression in the mid-term. METHODS: Longitudinal study (four occasions: baseline, 1, 3, and 12 months) of 243 patients with depressive symptomatology at three different services (primary care, outpatients, and hospital). Functioning was assessed on the first three occasions using the Global Assessment of Functioning (GAF), the WHODAS-2.0, and a self-reported functioning (SRF) rating scale. Growth mixture modeling of initial assessments served to estimate individual person-change parameters of each outcome. Person-growth parameters were used as predictors of major depressive episode at 12 months in a logistic regression model, adjusted by sex, age, healthcare level, and depression clinical status at third month. Predictive accuracy of all measures was assessed with area under the receiver operating curve (AUC). RESULTS: Of the 179 patients who completed all assessments, 58% had an active depression episode at baseline and 20% at 12 months (64% non-recoveries and 36% new onsets). Individual trends of change in functioning significantly predicted patient depression status a year later (AUC(WHODAS) = 0.76; AUC(GAF) = 0.92; AUC(SRF) = 0.93). CONCLUSIONS: Longitudinal modeling of functioning was highly predictive of patients' clinical status after 1 year. Although clinical and patient-reported assessment had high prognostic value, the use of very simple patient-reported outcome measures could improve case management outside specialized psychiatric services. FAU - Forero, Carlos G AU - Forero CG AUID- ORCID: 0000-0002-5895-5243 AD - CIBER en Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. cgarcia@imim.es. AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. cgarcia@imim.es. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. cgarcia@imim.es. FAU - Olariu, Elena AU - Olariu E AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. FAU - Alvarez, Pilar AU - Alvarez P AD - Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain. FAU - Castro-Rodriguez, Jose-Ignacio AU - Castro-Rodriguez JI AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. AD - Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain. FAU - Blasco, Maria Jesus AU - Blasco MJ AD - CIBER en Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. FAU - Vilagut, Gemma AU - Vilagut G AD - CIBER en Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. FAU - Perez, Victor AU - Perez V AD - Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain. AD - CIBER en Salud Mental (CIBERSAM), Madrid, Spain. FAU - Alonso, Jordi AU - Alonso J AD - CIBER en Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain. AD - Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain. AD - Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. CN - INSAyD Investigators LA - eng GR - PI16/00165/Instituto de Salud Carlos III/International GR - PI10/00530/Instituto de Salud Carlos III/International GR - PI13/00506/Instituto de Salud Carlos III/International GR - 2014SGR748/Departament d'Innovacio, Universitats i Empresa, Generalitat de Catalunya/International GR - 2017SGR452/Departament d'Innovacio, Universitats i Empresa, Generalitat de Catalunya/International GR - 2009SGR1095/Departament d'Universitats, Recerca i Societat de la Informacio/International PT - Journal Article DEP - 20180410 PL - Netherlands TA - Qual Life Res JT - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation JID - 9210257 SB - IM MH - Adult MH - Anxiety Disorders/psychology MH - Bipolar Disorder/psychology MH - Cohort Studies MH - Depression/*psychology MH - Depressive Disorder, Major/*psychology MH - Early Medical Intervention/*methods MH - Female MH - Humans MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Outpatients MH - Prognosis MH - Prospective Studies MH - Psychiatric Status Rating Scales MH - Psychotic Disorders/psychology MH - Quality of Life/*psychology MH - Self Report MH - Young Adult OTO - NOTNLM OT - Affective disorders OT - Early intervention OT - Functional disability OT - Questionnaire OT - WHODAS FIR - Alonso, Jordi IR - Alonso J FIR - Forero, Carlos G IR - Forero CG FIR - Vilagut, Gemma IR - Vilagut G FIR - Alvarez, Pilar IR - Alvarez P FIR - Castro-Rodriguez, Jose-Ignacio IR - Castro-Rodriguez JI FIR - Martin-Lopez, Luis Miguel IR - Martin-Lopez LM FIR - Abellanas, Lina IR - Abellanas L FIR - Garnier, Carrie IR - Garnier C FIR - Mas, Maria Rosa IR - Mas MR FIR - Perez-Gallo, Elena IR - Perez-Gallo E FIR - Reinoso, Marta IR - Reinoso M FIR - Barbaglia, Gabriela IR - Barbaglia G FIR - Fullana, Miquel A IR - Fullana MA FIR - Maydeu, Alberto IR - Maydeu A FIR - Brown, Anna IR - Brown A EDAT- 2018/04/11 06:00 MHDA- 2019/09/19 06:00 CRDT- 2018/04/12 06:00 PHST- 2018/04/06 00:00 [accepted] PHST- 2018/04/11 06:00 [pubmed] PHST- 2019/09/19 06:00 [medline] PHST- 2018/04/12 06:00 [entrez] AID - 10.1007/s11136-018-1853-0 [pii] AID - 10.1007/s11136-018-1853-0 [doi] PST - ppublish SO - Qual Life Res. 2018 Aug;27(8):2045-2056. doi: 10.1007/s11136-018-1853-0. Epub 2018 Apr 10.