Patient Functioning and Life Engagement: Unmet Needs in Major Depressive Disorder and Schizophrenia

Definitions of treatment success used in clinical trials of medications for serious mental illness have generally focused on reduction in symptoms assessed via observer-rated instruments such as the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale in MDD and the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale in schizophrenia. In recent years, there has been a shift toward incorporating outcomes into clinical research that are patient-reported and reflect outcomes and goals that are meaningful to the patient. These outcomes include aspects of functioning (eg, activities of daily living and role fulfillment), as well as life engagement, which interacts with symptomatic and functional outcomes and encompasses aspects such as motivation and vitality. In a recent roundtable meeting, a panel of 5 experts discussed life engagement and its relationship to symptoms and functioning in patients with major depressive disorder (MDD) and schizophrenia. This Academic Highlights summarizes their discussion.