Longitudinal bidirectional association between psychosocial function and depression in Chinese patients with clinically remitted depression: a cross-lagged panel model analysis.

Abstract

Background: Major depressive disorder (MDD) imposes serious effect on patient's psychosocial function, which hinders the full recovery from the disease and increases the risk of recurrence, although the participants had achieved clinical remission. To understand the relationship between psychosocial function and depressive symptoms could facilitate recurrence prevention. Therefore, the purpose of this study was to analyze the relation among psychosocial function and BDI score in Chinese patients with clinically cured depression within 1 year follow-up.

Methods: One hundred nineteen valid participants were assessed at baseline(t1), months 6(t2) and months 12(t3). Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms and indicate the possibility of depression level. Generic Quality of Life Inventory (GQOLI) was used to assessed the participants' psychosocial function(F), including body function (BF), psychological function (PF) and social function (SF). The application of a cross-lagged panel model (CLPM) approach revealed an association between BDI and psychosocial function.

Result: The CLPM results showed total average score of psychosocial function have reciprocal influence on BDI score. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 10.306, TLI = 0.959, CFI = 0.988 RMSEA = 0.115). And body function, psychological function, social function and BDI score also affect each other. Depressive symptoms and psychosocial function could predict scores of each other 6 months later. By comparing standardized cross-lagged path, only social function has a more pronounced impact on depressive symptoms, since the absolute effect of SFt1 → BDIt2 is larger than that of BDIt1 → SFt2 (a1 vs. b1 = -.267, SE = .108, P < 0.05, 95%CI[-.485,-.063]) and the absolute effect of SFt2 → BDIt3 is larger than that of BDIt2 → SFt3 (a2 vs. b2 = -.317, SE = .096, P < 0.01,95%CI[-.508,-.129]).

Conclusion: The current study showed a significant bidirectional association between depressive level and psychosocial function, and the social function exerted more effect on the depression.