ROLE OF THE FAMILY IN RECOVERY AND MAJOR DEPRESSION

Objective: Major depression is significantly influenced by the family environment of the depressed patient. In order to explore how family f unctioning relates to this illness, the authors examined changes in fa mily functioning over a 1-year course of major depression. Method: Sub jective (Family Assessment Device) and objective (McMaster Clinical Ra ting Scale) assessments of family functioning were collected at hospit alization and 6 and 12 months after discharge for 45 inpatients diagno sed with major depression and their family members. Patterns of family functioning were examined by subjective and objective perspectives, i nitial levels of functioning, and reports of patients and other family members. Results: Approximately 50% of families with a depressed memb er perceived their own family functioning as unhealthy; clinicians rat ed 70% of the families as unhealthy. While family functioning improved significantly from hospitalization through 12 months after discharge, the improvement was not uniform across all areas of functioning. Furt her, patients with good family functioning at hospitalization generall y maintained their healthy functioning and were more likely to recover by 12 months than patients with poor family functioning. Although ste ady in improvement in family functioning characterized the subjective ratings, objective assessments of family functioning suggested initial improvement followed by a decline from month 6 to month 12. Conclusio ns: Results show a clear association between family functioning and re covery from major depression. Different aspects of family life respond differently to the depressive illness; no one family dimension was un iquely related to outcome.