Depression and role functioning. Their relation during adolescence and adulthood

PhD ceremony: Ms. C.E. Verboom, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Depression and role functioning. Their relation during adolescence and adulthood

Promotor(s): prof. J. Ormel, prof. W.A. Nolen, prof. B.W.J.H. Penninx

Faculty: Medical Sciences

Depression is associated with impaired role functioning or disability in both adults and adolescents. Although many studies have focused on the relation between depression and role functioning disability, knowledge gaps remain. It is, for example, unknown if there are moderating factors in the association between depression and role functioning disability, and if there are differences between adolescent boys and girls. Consequently, the aim of this PhD thesis was to investigate these associations. During adolescence, we focused on the existence, strength and direction of the association between depressive problems and functioning at school and in the social domain. During adulthood, we focused on explaining heterogeneity in disability of patients with MDD. We used data from the TRAILS and NESDA studies.

The main findings point out that there is a strong relationship between depression and role functioning disability in both adolescents and adults. In adolescents, depressive problems precede subsequent poor functioning, mainly in the social domain, but poor functioning precedes subsequent depressive problems as well. In depressed adults, severity of depressive symptoms is the best correlate for disability, while it also shows synchrony of change with disability. Several illness characteristics, comorbid mental disorders, personal, and environmental characteristics, influence the extent to which severity of depressive symptoms leads to disability. The findings describe why disability appears in some depressed persons and not in others; and it identifies some triggering as well as buffering factors for disability.