Social functioning in depression: A review

Objective: This article reviews the available data on social functioning in depression and provides clinical guidelines and opinion on this important and expanding field. Data sources: A MEDLINE search was conducted to identify all English-langua ge articles (1988-1999) using the search terms depression and social functi oning, depression and social adjustment, depression and psychosocial functi oning, and social functioning and antidepressant. Further articles were obt ained from the bibliographies of relevant articles. Data synthesis: Depressive disorders are frequently associated with signifi cant and pervasive impairments in social functioning, often substantially w orse than those experienced by patients with other chronic medical conditio ns. The enormous personal, social, and economic impact of depression, due i n no small part to the associated impairments in social functioning, is oft en underappreciated. Both pharmacologic and psychotherapeutic approaches ca n improve social impairments, although there is a lack of extended, randomi zed controlled trials in this area using consistent assessment criteria. Conclusion: Despite this lack, it is becoming clear that not all treatments are equally effective in relieving the impaired social functioning associa ted with depressive disorders. Furthermore, efficacy in relieving the core symptoms of depression does not necessarily guarantee efficacy in relieving impaired social functioning.