Social functioning and the treatment of depression

For economic and scientific reasons, there has been a recent increase in the use of social functioning as an outcome measure in clinical trials of psychotropic drugs. The new antidepressants are more expensive than the older agents, and improvement in social functioning, e.g., return to work, may justify their use. New assessments (e.g., vitality, motivation, and performance) that go beyond symptom reduction may also capture a broader spectrum of outcomes for the newer drugs. This article presents the historical background and rationale for interest in social functioning as an outcome of treatment with psychotropic medications, presents recent examples of measures of social functioning from clinical trials of new antidepressants, discusses several of the methods for assessing social functioning, and suggests how these assessments can be used in clinical practice.