OBJECTIVES: To assess family functioning from patients’ and partners’ perspectives to better understand the impact of depression on family functioning; To develop and test patient and partner versions of a new self-reported measure, the Depression and Family Functioning Scale (DFFS), for use in clinical trials.
METHODS: First, 32 in-depth interviews were conducted separately with adults with moderate-to-severeMDDand their respective partners to 1) gather qualitative data describing the impact of depression on family functioning, and 2) identify constructs relevant to measuring this impact. Next, based on the interview results and a targeted literature review conducted to supplement these results, 26 items were drafted to address each aspect of family functioning likely to be affected by depression. Questionnaire items were then tested and refined through two iterative sets of cognitive interviews with a total of 15 MDD patients and 15 partners of MDDpatients to allow for enhanced comprehension of questionnaire items, as well as optimization of the recall period and response scales used in the final DFFS.
RESULTS: Depression negatively affects family functioning, most notably through poorer communication, increased conflicts, decreased family interaction, and decreased intimacy. Family functioning constructs most commonly referenced in the literature review included communication, satisfaction, and cohesion. Draft DFFS items generally tested well and only minor modifications were made to the items after the second set of interviews to further facilitate comprehension and accurate responses. Both patients and partners found the final 15 DFFS items important and relevant.
CONCLUSIONS: Depression negatively affects family functioning in multiple ways. The DFFS is a brief scale designed to evaluate depression’s impact on family functioning in patients with MDD and their partners. The DFFS has the potential to provide unique and important information facilitating more comprehensive evaluation of new treatments in clinical trial settings.
