Development of a family functioning scale for major depressive disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Family Studies

Background:

• Major depressive disorder (MDD) significantly impacts interpersonal relationships and family dynamics.
• Existing measures may not fully capture the multifaceted effects of depression on family functioning from both patient and partner perspectives.

Purpose of the Study:

• To explore the impact of MDD on family functioning through patient and partner viewpoints.
• To develop and psychometrically validate a new self-report measure, the Depression and Family Functioning Scale (DFFS).
• To establish a tool for assessing depression's effects on families in clinical trials.

Main Methods:

• Concept elicitation interviews were conducted with 32 adults diagnosed with moderate-to-severe MDD and their partners.
• A 26-item draft scale was developed based on interview data.
• Iterative cognitive debriefing interviews refined the scale, resulting in the 15-item DFFS.

Main Results:

• Depression adversely affects family functioning, leading to communication issues, increased conflict, reduced interaction, and diminished intimacy.
• No existing instruments adequately measured all relevant domains or were validated in target populations.
• The developed DFFS items were well-received by patients and partners, addressing key concepts of importance.

Conclusions:

• The DFFS is a valid tool for evaluating depression's impact on family functioning.
• The DFFS can enhance the comprehensive assessment of novel treatments in clinical trials.
• Depression severity showed minimal impact on the core concepts of family functioning identified, with milder cases sometimes offering greater articulation of changes.