Underwriting psychiatric impairments, with emphasis on depression. Part III: Morbidity and estimating degree of impairment.

This issue was addressed in the Medical Outcomes Study, which compared the functioning and well-being of patients with (1) depressive symptoms, (2) a depressive disorder (major depression, dysthymia, or major depression plus dysthymia), and (3) eight current chronic medical conditions (hypertension, diabetes, angina, advanced coronary heart disease, arthritis, back problems, lung problems, or a gastrointestinal disorder).1 In this study, both depressive symptoms and depressive disorders were associated with significant limitations in functioning and wellbeing. The poor functioning in the two psychiatric groups was actually comparable to or worse than that of patients with chronic medical conditions.