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Perceived family functioning and its association with depressive symptoms severity and quality of life in patients with major depressive disorder

Published online by Cambridge University Press:  19 July 2023

K. Koutra*
Affiliation:
1Department of Psychology, University of Crete, Rethymnon
G. Mavroeides
Affiliation:
1Department of Psychology, University of Crete, Rethymnon
M. Basta
Affiliation:
2Department of Psychiatry & Behavioral Sciences, Faculty of Medicine
A. Vgontzas
Affiliation:
3Mobile Mental Health Unit, University Hospital of Heraklion, University of Crete, Heraklion, Greece 4Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State College of Medicine, Hershey, PA, United States
*
*Corresponding author.

Abstract

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Introduction

Studies have shown that family factors affect the development, maintenance and course of major depressive disorder (MDD).

Objectives

The present study aimed to prospectively investigate whether dysfunctional family functioning is associated with meaningful clinical outcomes including symptom severity and quality of life (QoL) in patients with MDD.

Methods

A total of 114 patients with a clinical diagnosis of MDD (83.3% females, aged 47.25±13.98 years) participated in the study. Participants were recruited from the outpatient clinic, Department of Psychiatry and the mobile mental health unit of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group. Family functioning was assessed in terms of cohesion, flexibility, communication and satisfaction dimensions (FACES IV) at baseline. Depression severity (BDI) and QoL (WHOQOL-BREF) were assessed about 10 months after the baseline assessment (9.56±2.52).

Results

Conceptually, the cohesion dimension contains Balanced Cohesion (central area) with Disengaged (low unbalanced) and Enmeshed (high unbalanced) dimension, and the flexibility dimension contains Balanced Flexibility (central area) with Rigid (low unbalanced) and Chaotic (high unbalanced) dimension. Multivariable analysis adjusting for confounding variables such as patients’ educational level, residence, family structure, pharmacotherapy, psychotherapy, and history of suicide attempts indicated that Balanced Cohesion was positively associated with increased levels of patients’ psychological QoL. Moreover, two out of four unbalanced scales - Enmeshed and Chaotic - were negatively related to lower psychological QoL. The findings also demonstrated that Enmeshed scale was positively associated with higher depressive symptoms. Finally, lower family communication was related to increased depressive symptoms, whereas lower family satisfaction was associated with patients’ lower psychological QoL.

Conclusions

Family environmental factors appear to play an important role in clinical outcomes of MDD. Family interventions targeting dysfunctional family interactions by promoting awareness of family dynamics could improve the emotional well-being of patients with MDD.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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