Questionnaire effectively measures psychosocial functioning in MDD

A questionnaire effectively measured psychosocial functioning of patients with major depressive disorder, according to study results published in General Psychiatry.

“The importance of psychosocial functioning in the assessment, diagnosis and treatment of major depressive disorder (MDD) is widely recognized,” Xiujuan Zhang, of the department of medical psychology at Nanjing Medical University in China, and colleagues wrote. “It has been found that patients with MDD have significant impairments in psychosocial functioning, and the impairments do not often entirely disappear even after patients achieve remission of depressive symptoms; this is closely related to the recurrence of MDD.”

Zhang and colleagues sought to develop a professional questionnaire for assessing psychosocial functioning in MDD. They used a literature review, an open-ended questionnaire survey and patient interviews to create a theoretical model of psychosocial functioning and formed an initial questionnaire that included four dimensions. They conducted two rounds of testing that incorporated items analysis and exploratory factor analysis and then created a finalized questionnaire.

Using a convenience sampling method, researchers selected 460 patients with MDD from six psychiatric hospitals for formal testing. They randomly selected and retested 40 patients after 1 week to examine the test-retest reliability of the scale. They used the Patient Health Questionnaire-9 (PHQ-9), Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-SQ), Sheehan Disability Scale (SDS) and Dysfunctional Attitude Scale (DAS) to provide major standards for assessing the criterion validity of the questionnaire. Further, the used correlation analysis, confirmatory factor analysis and internal consistency reliability testing to investigate other psychometric characteristics of the finalized questionnaire.

In the Psychosocial Functioning Questionnaire (PFQ), Zhang and colleagues included three dimensions, which were psychological cognitive functioning, subjective well-being and social functioning, with 18 items overall. They reported overall internal consistency reliability of the questionnaire of 0.957, as well as test-retest reliability of 0.84. Confirmatory factor analysis revealed good fit of the model, with a Goodness of Fit Index score of 0.888. Zhang and colleagues noted a significant association between total score of PFQ and the total score of PHQ-9, DAS, SDS and Q-LES-SQ.

“This article describes a more relevant psychosocial functioning assessment tool for depressed patients, which helps to assess more comprehensively for treatment, recovery and relapse prevention of depression,” Zhang and colleagues wrote. “Simultaneously, it increases attention to the recovery of patients’ psychosocial functioning, thus advancing

the quality of treatment, reducing the relapse rate and decreasing the overall medical burden. Second, this questionnaire could implement an explicit and supportive method for assessing the efficacy of the psychotherapy for depression, thereby stimulating the development and use of psychological intervention programs for depression.”