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Although studies have examined how depressed patients’ baseline characteristics predict depression course, still needed are studies of how depression course is associated with modifiable long-term outcomes. This study examined six outcomes of three groups representing distinct depression courses (low baseline severity, rapid decline; moderate baseline severity, rapid decline; and high baseline severity, slow decline): medical functioning, coping patterns, family functioning, social functioning, employment, and work functioning. Adults with depression at baseline (N = 382; 56% women) were followed for 23 years on self-reported outcomes (79% response rate). Data from the baseline assessment and follow-ups (1, 4, 10, and 23 years) were used in a longitudinal analysis to examine associations between depression course and outcomes. All depression course groups declined on medical and social functioning and employment over follow-up. The high- and moderate-severity depression course groups reported poorer coping patterns than the low-severity group. The high-severity depression course group reported poorer family functioning than the moderate-severity group, and had the poorest work functioning outcome, followed by the moderate-severity and then the low-severity groups. Patients with a high- or moderate-severity depression course may benefit from treatment that manages coping patterns and improves family and work functioning.

The role of depression course on life functioning and coping outcomes from baseline through 23-year follow-up