Table 4.
Changes in Depressed Status and Changes in Functional Outcomes Across the 3-Year Study
| Outcome domain/variable | Beginning and ending depressed statusa | Beginning value | Ending value | Difference |
|---|---|---|---|---|
| Resource utilization | ||||
| Prior 6 months hospitalization, % (n) | D-D | 21.7 (186) | 18.4 (158) | −3.3 |
| D-ND | 21.9 (113) | 14.0 (72) | −8.0*** | |
| ND-D | 17.4 (71) | 15.2 (62) | −2.2 | |
| ND-ND | 13.9 (297) | 10.6 (227) | −3.3*** | |
| Hospitalized duration, mean (SD) | D-D | 6.1 (23.6) | 6.0 (23.1) | −0.1 (25.6) |
| D-ND | 8.7 (32.7) | 11.4 (47.3) | 2.7 (40.0) | |
| ND-D | 5.6 (26.6) | 5.2 (24.9) | −0.4 (33.2) | |
| ND-ND | 7.7 (37.0) | 7.1 (38.8) | −0.6 (33.6) | |
| Emergency psychiatric services, % (n) | D-D | 12.4 (109) | 11.4 (100) | −1.0 |
| D-ND | 12.6 (66) | 5.4 (28) | − 7.3*** | |
| ND-D | 5.8 (24) | 10.9 (45) | 5.1** | |
| ND-ND | 3.9 (84) | 2.7 (59) | −1.2* | |
| Emergency room visit, % (n) | D-D | 15.5 (51) | 12.8 (42) | −2.7 |
| D-ND | 10.5 (22) | 7.6 (16) | −2.9 | |
| ND-D | 11.7 (21) | 11.7 (21) | 0.0 | |
| ND-ND | 6.2 (65) | 4.8 (50) | −1.4 | |
| Contacts with psychiatrist | D-D | 4.6 (6.8) | 3.7 (3.5) | −0.9 (7.0)* |
| D-ND | 3.7 (3.2) | 3.6 (5.4) | −0.1 (5.3) | |
| ND-D | 3.8 (4.3) | 3.7 (5.4) | −0.2 (6.0) | |
| ND-ND | 3.5 (5.1) | 3.1 (4.7) | −0.4 (6.3) | |
| Safety to self and others | ||||
| Violent behaviors, % (n) | D-D | 12.0 (105) | 10.7 (94) | −1.3 |
| D-ND | 7.7 (40) | 5.2 (27) | −2.5 | |
| ND-D | 4.6 (19) | 6.0 (25) | 1.5 | |
| ND-ND | 3.0 (65) | 3.1 (68) | 0.1 | |
| Arrested/jailed, % (n) | D-D | 5.8 (51) | 4.8 (42) | −1.0 |
| D-ND | 5.0 (26) | 4.0 (21) | −1.0 | |
| ND-D | 4.6 (19) | 4.4 (18) | −0.2 | |
| ND-ND | 3.5 (77) | 2.4 (52) | −1.2* | |
| Victim of crime, % (n) | D-D | 15.2 (134) | 14.9 (131) | −0.3 |
| D-ND | 14.0 (73) | 9.0 (47) | −5.0* | |
| ND-D | 8.5 (35) | 10.6 (44) | 2.2 | |
| ND-ND | 5.8 (126) | 5.5 (119) | −0.3 | |
| Suicidal thinking, % (n) | D-D | 34.6 (304) | 31.6 (277) | −3.1 |
| D-ND | 22.8 (119) | 9.0 (47) | −13.8*** | |
| ND-D | 10.4 (43) | 20.5 (85) | 10.1*** | |
| ND-ND | 3.3 (72) | 2.9 (63) | −0.4 | |
| Suicidal attempts, % (n) | D-D | 5.4 (47) | 4.8 (42) | −0.6 |
| D-ND | 4.0 (21) | 1.0 (5) | −3.1** | |
| ND-D | 1.2 (5) | 1.9 (8) | 0.7 | |
| ND-ND | 0.6 (13) | 0.6 (14) | 0.0 | |
| Substance use | ||||
| Alcohol-related problems, mean (SD) | D-D | 0.3 (0.9) | 0.3 (0.8) | −0.0 (0.8) |
| D-ND | 0.3 (0.9) | 0.2 (0.6) | −0.1(0.8)*** | |
| ND-D | 0.2 (0.6) | 0.3 (0.8) | 0.1 (0.8)*** | |
| ND-ND | 0.1 (0.5) | 0.1 (0.5) | −0.0 (0.6) | |
| Drug-related problems, mean (SD) | D-D | 0.2 (0.6) | 0.2 (0.6) | 0.0 (0.7) |
| D-ND | 0.2 (0.7) | 0.1 (0.5) | − 0.1 (0.7)** | |
| ND-D | 0.1 (0.6) | 0.2 (0.7) | 0.1 (0.6)* | |
| ND-ND | 0.1 (0.4) | 0.1 (0.4) | − 0.0 (0.4) | |
| Substance use, % (n) | D-D | 27.3 (240) | 25.3 (223) | − 1.9 |
| D-ND | 27.0 (141) | 21.7 (113) | − 5.4* | |
| ND-D | 25.1 (104) | 29.0 (120) | 3.9 | |
| ND-ND | 20.4 (415) | 19.4 (424) | −1.0 | |
| Productivity | ||||
| Work for pay, % (n) | D-D | 18.1 (159) | 16.1(142) | −1.9 |
| D-ND | 22.4 (117) | 24.3 (127) | 1.9 | |
| ND-D | 23.5 (97) | 23.7 (98) | 0.2 | |
| ND-ND | 25.5 (556) | 26.9 (587) | 1.4 | |
| Work days/week, mean (SD) | D-D | 11.7 (7.9) | 11.2 (7.2) | −0.4 (8.5) |
| D-ND | 12.0 (6.8) | 12.5 (7.3) | 0.4 (6.5) | |
| ND-D | 12.5 (7.2) | 11.5 (7.2) | −0.9 (7.5) | |
| ND-ND | 12.7 (7.4) | 13.6 (7.4) | 0.9 (7.4)* | |
| Work hours/day, mean (SD) | D-D | 4.5 (2.4) | 4.5 (2.3) | 0.0 (1.8) |
| D-ND | 5.3 (3.4) | 5.3 (3.1) | −0.0 (2.1) | |
| ND-D | 5.3 (2.4) | 5.3 (3.3) | −0.0 (3.3) | |
| ND-ND | 5.2 (2.6) | 5.2 (2.5) | 0.0 (2.5) | |
| Occupational functioning (SD) | D-D | 8.4 (5.9) | 8.4 (5.9) | 0.0 (5.4) |
| D-ND | 8.8 (6.5) | 10.6 (7.0) | 1.8 (6.3)*** | |
| ND-D | 10.9 (7.1) | 9.7 (6.6) | −1.2 (6.5)*** | |
| ND-ND | 11.1 (7.0) | 11.3 (7.0) | 0.2 (6.5) | |
| Productivity, % (n) | D-D | 64.3 (566) | 63.0 (554) | −1.4 |
| D-ND | 68.1 (356) | 73.0 (382) | 5.0 | |
| ND-D | 74.6 (309) | 70.3 (291) | −4.4 | |
| ND-ND | 69.9 (1528) | 72.5 (1584) | 2.6 | |
| Activities/Relationships | ||||
| Daily activity, mean (SD) | D-D | 3.3 (1.2) | 3.3 (1.2) | −0.1 (1.0) |
| D-ND | 3.3 (1.2) | 3.3 (1.2) | −0.0 (1.0) | |
| ND-D | 3.5 (1.2) | 3.4 (1.2) | −0.1 (1.0) | |
| ND-ND | 3.4 (1.2) | 3.4 (1.3) | 0.0 (0.9) | |
| Leisure activity, mean (SD) | D-D | 2.6 (1.2) | 2.6 (1.2) | −0.1 (1.2) |
| D-ND | 2.7 (1.2) | 2.8 (1.1) | 0.1 (1.2) | |
| ND-D | 2.9 (1.1) | 2.8 (1.1) | −0.1 (1.2) | |
| ND-ND | 2.7 (1.2) | 2.8 (1.2) | 0.0 (1.2) | |
| Common activities, mean (SD) | D-D | 6.6 (2.1) | 6.5 (2.1) | −0.1 (1.7) |
| D-ND | 6.5 (2.1) | 6.7 (2.3) | 0.2 (1.8)* | |
| ND-D | 6.8 (2.2) | 6.5 (2.2) | −0.3 (1.8)*** | |
| ND-ND | 6.4 (2.3) | 6.5 (2.3) | 0.1 (1.8)* | |
| Social relationships, mean (SD) | D-D | 2.7 (1.2) | 2.6 (1.2) | −0.1 (1.2) |
| D-ND | 2.8 (1.2) | 2.9 (1.2) | 0.1 (1.3) | |
| ND-D | 2.9 (1.2) | 2.7 (1.2) | −0.3 (1.3)*** | |
| ND-ND | 3.0 (1.2) | 2.9 (1.2) | −0.0 (1.2) | |
| Interpersonal functioning, mean (SD) | D-D | 17.2 (8.6) | 17.1 (8.4) | −0.1 (7.8) |
| D-ND | 19.8 (9.1) | 22.3 (9.8) | 2.6 (9.3)*** | |
| ND-D | 22.7 (9.9) | 19.3 (9.2) | −3.3 (9.0)*** | |
| ND-ND | 23.1 (10.3) | 23.1 (9.9) | 0.0 (8.7) | |
| Family relationships, mean (SD) | D-D | 4.1 (1.6) | 4.1 (1.6) | 0.0 (1.7) |
| D-ND | 4.4 (1.6) | 4.8 (1.4) | 0.4 (1.8)*** | |
| ND-D | 4.7 (1.5) | 4.4 (1.6) | −0.3 (1.6)*** | |
| ND-ND | 5.2 (1.4) | 5.2 (1.4) | 0.0 (1.6) | |
| Quality of life | ||||
| Quality of life, overall, mean (SD) | D-D | 51.7 (17.9) | 51.2 (17.8) | −0.4 (14.8) |
| D-ND | 55.1 (19.6) | 63.2 (20.4) | 8.1 (18.5)*** | |
| ND-D | 64.9 (22.0) | 56.3 (20.0) | −8.6 (17.7)*** | |
| ND-ND | 65.0 (21.9) | 65.3 (21.3) | 0.3 (17.1) | |
| Motivation level, mean (SD) | D-D | 19.0 (7.1) | 19.0 (7.1) | −0.1 (6.1) |
| D-ND | 20.4 (8.0) | 23.2 (7.7) | 2.8 (7.3)*** | |
| ND-D | 23.9 (8.1) | 20.5 (7.7) | −3.3 (7.3)*** | |
| ND-ND | 24.1 (8.0) | 23.8 (7.8) | −0.3 (6.7) | |
| Global level of functioning, mean (SD) | D-D | 36.4 (10.9) | 35.6 (10.2) | −0.8 (10.4)* |
| D-ND | 39.2 (11.7) | 42.5 (11.4) | 3.3 (12.1)*** | |
| ND-D | 43.9 (12.3) | 38.3 (10.4) | −5.7 (12.5)*** | |
| ND-ND | 45.4 (12.5) | 45.2 (12.2) | −0.2 (11.6) | |
| Mental functioning, mean (SD) | D-D | 30.8 (11.0) | 31.3 (10.9) | 0.5 (12.0) |
| D-ND | 36.1 (11.7) | 41.8 (11.4) | 5.7 (13.5)*** | |
| ND-D | 41.2 (11.5) | 36.7 (11.2) | −4.5 (13.7)*** | |
| ND-ND | 48.0 (11.1) | 48.4 (11.1) | 0.4 (12.0) | |
| Physical functioning, mean (SD) | D-D | 44.2 (11.9) | 43.5 (11.7) | −0.8 (11.0)* |
| D-ND | 46.2 (11.0) | 46.3 (10.7) | 0.1 (11.4) | |
| ND-D | 46.7 (10.9) | 44.8 (11.5) | −1.9 (11.7)** | |
| ND-ND | 46.5 (9.5) | 46.4 (9.5) | −0.1 (10.0) | |
| Medication adherence, mean (SD) | D-D | 1.6 (0.8) | 1.6 (0.9) | 0.0 (1.0) |
| D-ND | 1.5 (0.9) | 1.4 (0.6) | −0.2 (1.0)*** | |
| ND-D | 1.4 (0.6) | 1.5 (0.8) | 0.1 (0.9)** | |
| ND-ND | 1.3 (0.6) | 1.3 (0.6) | −0.0 (0.8) | |
| Independent housing, % (N) | D-D | 73.0 (631) | 73.6 (637) | 0.7 |
| D-ND | 68.0 (351) | 71.1 (367) | 3.1 | |
| ND-D | 72.4 (296) | 73.6 (301) | 1.2 | |
| ND-ND | 67.3 (1460) | 68.3 (1483) | 1.1 | |
| General life satisfaction, mean (SD) | D-D | 3.7 (1.5) | 3.7 (1.5) | 0.0 (1.6) |
| D-ND | 4.2 (1.5) | 4.8 (1.4) | 0.5 (1.7) *** | |
| ND-D | 4.7 (1.4) | 4.3 (1.6) | −0.4 (1.7)*** | |
| ND-ND | 5.2 (1.3) | 5.3 (1.2) | 0.1 (1.4)** |
a
Subjects who changed or maintained their depressed status during any 2 consecutive depression assessments across the 3-year study. Group sizes: D-D N=881, D-ND N=524, ND-D N=415, ND-ND N=2190. Group sizes differ across outcome variables due to missing values.
Significant group differences
*
p<.05;
**
p ≤ .01;
***
p ≤ .001
Abbreviations: D-D, Depressed to Depressed; D-ND, Depressed to Non-Depressed; ND-D, Non-depressed to Depressed; ND-ND, Non-depressed to Non-depressed.