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Mental health and well-being in a 6-year follow-up of patients with depression

Assessments of patients and clinicians



Psychiatric patients have the right to strive for well-being and not only be confined to symptom reduction. Studies are needed to assess global well-being during recovery from depression by comparing the assessments of patients and clinicians.


A 6-year natural follow-up of 185 depressive out-patients was carried out with health questionnaires at baseline, 0.5, 1, 2 and 6 years, including scales on depression (BDI, HDRS), general psychopathology (SCL), functional capacity (GAF, SOFAS) and life satisfaction (LS). A structured diagnostic interview was carried out at baseline, 2 and 6 years. Complete follow-up data were obtained from 121 patients.


In general, depressive patients mainly attained a normal mood, adequate functional capacity and life satisfaction. Those with a slow recovery improved with successive treatment contacts, eventually reaching levels of mental health not significantly different from the others. Throughout the follow-up, recovery was similarly shown with the self-reported BDI-21, SCL-90 and LS-4, while intercorrelations between clinician ratings were low at baseline.


Adequate mental health and global well-being can be reached among depressive patients, but it may take time in treatment. Subjective assessments are reliable. The 4-item life satisfaction scale is a global well-being indicator and a valid treatment outcome measure.

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This study was supported by the Academy of Finland (grant 116996).

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Correspondence to Heli Koivumaa-Honkanen MD, PhD, MPH.

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Koivumaa-Honkanen, H., Tuovinen, T.K., Honkalampi, K. et al. Mental health and well-being in a 6-year follow-up of patients with depression. Soc Psychiat Epidemiol 43, 688 (2008).

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Key words

  • depression
  • personal satisfaction
  • psychopathology
  • psychiatric status rating scales
  • functional capacity