SOCIAL SUPPORT AND RECOVERY AMONG DEPRESSED OUTPATIENTS

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This proposed study of Social Support and Recovery Among Depressed Outpatients requests 1 year of funding to investigate the effect across the lifespan of different social support dimensions on the course and outcome of outpatients with major depressive disorder. The social support field has moved beyond unidimensional assessments of support, and it is particularly important to extend these efforts to geriatric outpatients. The primary aims of this study are to examine the extent to which the effects of social support on short term (3 and 6 month) symptom improvement and recovery (1) vary by specific dimensions of social support (e.g., network structure, interaction frequency, perceived emotional support, and instrumental aid), and (2) are the same or different in elderly adults as younger adults. A third aim is to identify factors that potentially mediate or moderate observed relationships between social support and changes in depressive symptoms, including whether support increases adherence to psychiatric treatment and whether disability moderates the effect of support. To address these aims, we will compare adult (18-64) and geriatric (65 and above) outpatients with major depression who are treated naturalistically at 8 diverse academic, hospital, county, and voluntary clinics in Westchester County. B/Start funding will build on and extend an existing data set and will allow us to continue to follow up the entire sample longitudinally at 2 follow-up periods: 3 and 6 months. B/Start funding will also support analyses of the data. A trained research assistant will conduct interviews to diagnose major depression using the SCID (Spitzer et al., 1995) and will assess depression severity using the Hamilton (Hamilton, 1960), different dimensions of social support using the Duke Social Support Index (George et al., 1989), and other variables at baseline and follow-up periods.