Social adjustment in dysthymia, double depression and episodic major depression.

We contrasted the overall social functioning of pure dysthymics, double depressives, episodic major depressives and normal controls using both interview and self-report measures of social functioning and depression. In addition, we used hierarchical multiple regression to assess the differential impact of several variables (comorbid personality, anxiety and substance use disorders, life stress, duration of dysthymia and severity of depressive symptomatology) on social functioning in the dysthymics and double depressives. Participants included 41 outpatients with early-onset dysthymia alone, 56 outpatients with early-onset dysthymia and concurrent major depression, 45 outpatients with episodic major depression and 45 normal controls. All 3 patient groups were found to be significantly more impaired than normal controls in overall functioning, as well as in every specific role area. Double depression was found to be particularly impairing, both in overall functioning and in every specific role area. In dysthymic patients with and without concurrent major depression, current depressive symptomatology is the strongest predictor of impairment. Taken together, these data suggest that chronic, low-grade depressive symptoms and acute, moderate depressive symptoms have similar, significant and additive effects on social adjustment.