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Results From the Medical Outcomes Study

Kenneth B. Wells, MD, MPH; Anita Stewart, PhD; Ron D. Hays, PhD; M. Audrey Burnam, PhD; William Rogers, PhD; Marcia Daniels, MD; Sandra Berry, MS; Sheldon Greenfield, MD; John Ware, PhD

JAMA. 1989;262(7):914-919.

Abstract
We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11 242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning.

(JAMA. 1989;262:914-919)

Author Affiliations
From The RAND Corp, Santa Monica, Calif (Drs Wells, Hays, Burnam, Rogers, Daniels, Greenfield, and Ware and Ms Berry); Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute and Hospital, UCLA School of Medicine, Los Angeles, Calif (Dr Wells); Institute for Health and Aging, University of California, San Francisco (Dr Stewart); and Institute for the Improvement of Medical Care and Health, New England Medical Center Hospitals, Boston, Mass (Drs Greenfield and Ware).

Footnotes
The conclusions are those of the authors and do not necessarily reflect the opinion of the sponsors or the authors' institutions.

Reprint requests to The RAND Corp, 1700 Main St, Santa Monica, CA 90406-2138 (Dr Wells).

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