Abstract
ObjectiveIn mental health care, treatment effects are commonly monitored by symptom severity measures. This study aimed to investigate the relationship between symptom severity and well‐being in the treatment of patients with major depressive disorder (MDD).MethodsAdult MDD outpatients (n = 77) were administered the Quick Inventory of Depressive Symptomatology—Self‐Report (QIDS‐SR), the Outcome Questionnaire (OQ‐45), and the Mental Health Continuum‐Short Form (MHC‐SF) before treatment and 6 months later.ResultsSymptom severity correlated moderately with well‐being at baseline and strongly at follow‐up. Reliable change index scores showed improvement on the QIDS‐SR, OQ‐45, and MHC‐SF in 65%, 59%, and 40%, respectively. A quarter of patients improved in symptom severity but not well‐being (Inventory of Depressive Symptomatology—Self‐Report [IDS‐SR]: 25%; OQ‐45: 24%).ConclusionFindings suggest that symptom severity and subjective well‐being are related, but distinct concepts. Several reasons for the stronger improvements in symptoms than in well‐being are discussed.
Highlights
Major depressive disorder (MDD) is the leading cause of disease burden worldwide (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators, 2016; Rehm & Shield, 2019), with a lifetime prevalence of about 15%–18% worldwide (Kessler & Bromet, 2013; Kraus et al, 2019; Malhi & Mann, 2018)
We explored the relationship between changes in depressive symptom severity measures, general psychopathology, and changes in well‐being during treatment in patients with MDD
At the second measurement strong negative correlations were found between depressive symptom severity and well‐being (r = −.79; p < .001) and between general psychopathology and well‐being (r = −.80; TABLE 3 Correlations between depressive symptom severity (IDS‐social roles. **p < .01 (SR)), general psychopathology (OQ‐45), and well‐being (MHC‐SF) at baseline
Summary
Major depressive disorder (MDD) is the leading cause of disease burden worldwide (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators, 2016; Rehm & Shield, 2019), with a lifetime prevalence of about 15%–18% worldwide (Kessler & Bromet, 2013; Kraus et al, 2019; Malhi & Mann, 2018). Available evidence‐based treatments for MDD are moderately effective, with about one‐third of patients responding to the initial treatment (Al‐Harbi, 2012; Maslej et al, 2020; Wittchen et al, 2011). Close monitoring of improvement is highly important. To this end, many treatment facilities implemented routine outcome monitoring (ROM) to systematically evaluate treatment effectiveness and to timely switch treatment. Disease severity and the pathology of the patient are the focus of treatment. The relevance of symptom reduction for the recovery process of patients with psychiatric disorders has been questioned, since mental health is considered much more than the absence of symptoms of psychopathology (Fava & Guidi, 2020; Keyes, 2002, 2005). The World Health Organization (WHO) views mental health as “a state of well‐being in which the individual realizes his or her own abilities, can cope with the normal stressors of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (Galderisi et al, 2015)
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