الفهرس 
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Abstract
Summary
Major depressive disorder (MDD) is a multifaceted condition with emotional (e.g., feelings of worthlessness or diminished interest in life), cognitive (e.g., trouble concentrating), and physical symptoms (e.g., insomnia or fatigue), which are important for psychosocial functioning. The functional impairment observed in patients with MDD extends to work, social, and family life and has important consequences for their health-related quality of life (Baune BT and christensen MC, 2019).
One of the most important non-pharmacological treatments for bipolar disorder is “psychoeducation”( González-Pinto, A, et al., 2016). Psychoeducation is an educational method that provides information on the nature of mental disorders, including etiology, treatment methods, outcomes, prognosis, progression, recurrence, etc. Psychoeducation can be delivered to patients, their families, or both. This approach can improve families’ awareness about mental disorders (Ershad et al., 2021). There are some studies regarding the effectiveness of psychoeducation programs in reducing symptoms and recurrence of mental disorders. As well, psychoeducation can improve the quality of life of patients with mental disorders (Rahmani F, et al., 2016).
Problem-solving therapy (PST) aims to reduce psychopathology and maximize the quality of life by developing constructive problem-solving skills for more effective coping. PST is based on the premise that depression is maintained by ineffective problem-solving and the resultant poor coping, low self-efficacy, and negative emotions. To date, PST is the only psychotherapy for late-life depression that has demonstrated efficacy relative to a supportive therapy control as well as CBT among medically ill older adults (Renn, B, & Areán, P. A. 2017).
Aim of the study
This study aimed to determine the impact of psychosocial intervention on the life functioning of patients with depressive disorder.
Materials
A. Research design:
An experimental pretest-posttest and follow up controlled design was used.
B. Setting of the study:
The study was carried out in neuropsychiatric and neurosurgery hospital in the outpatient psychiatric clinics. Assiut University Hospital it is the biggest hospital in Upper Egypt that provides services for Assiut city and most of the neighboring governorates. The hospital contains a psychiatric department’s emergency, psychiatric in-patient’s male and female, addiction department, and outpatients’ psychiatric clinics. The total number of beds in a psychiatric hospital is 94 beds, 12 beds in the emergency department, 30-bed females Psychiatry unit, 36 beds in the male Psychiatry department, and 16 beds in the addiction unit.
C. Subjects: -
Subjects of the study included 70 convenient patients, with depressive disorder consisting of (35) patients (study group) and (35) patients (control group), from the outpatient clinics for a period (from the first of January 2019 to the end of August 2019).
D. Tools: Four tools were used to collect data for this study.
Tool (1): Structured interview questionnaire (Demographic and clinical characteristics) (Appendix I)
This, tool was developed by the researcher, and it consists of questions related to, demographic characteristics of patients, including name, age, sex, occupation, level of education, marital status, and parental consanguinity. Clinical data includes the date of admission number of hospitalization and the presence of family history.
Tool (2): Beck depression inventory scale (BDI) (Appendix II)
This scale has been developed by Beck, first published in (1961) and later revised in (1969) and copyrighted in (1979) Polgar & Michael, (2003), and was translated to Arabic by Abdel- Khalek, (1998) and back-translated into English to check validity and reliability and was updated by Basher, (2010). This scale contains 21 questions about how the subject has been feeling; each question has an asset of at least four possible answer choices, ranging from 0 to 3, and indicated the severity of the symptom. The score was ranged from (0-63) and the levels of depression were categorized as follows:
• Minimal or no depressive symptoms range from zero to13.
• Mild depression ranges from 14 to 19.
• Moderate depression ranges from 20 to 28.
• Severe depression ranges from 29 to 63.
Tool (3): Quality of Life Scale (QoL) (Baxter et al., 1998) (Appendix III)
This scale was developed by Baxter et al. 1998; to assess areas of functional status considered important to persons with varying levels of wellness and disability. The response scale for the QoL ranges from 0, extremely dissatisfied, to 10, extremely satisfied. 19 items resulted in satisfaction in three factors ( Satisfaction with physical health and well-being, satisfaction with social health and well-being, Satisfaction with cognitive health and well-being. The total score of each subscale was done by counting scores assigned to each question in each subscale.
Tool (4): Impairment function scale (SDS) (Appendix IV):
This scale was developed by Sheehan, (1983) to assess functional impairment in three interrelated domains: work life, social and family life. The response of the patient rating from zero to 10 where 0 considered no impairment and 10 extremely impaired. Its validity and reliability have been investigated in several studies (Sheehan et al., 2008).
Pilot study :-
It was carried out on seven patients to test the structured form of tools. The pilot study demonstrated that the questions were clear.
The main results yielded by this study were: -
There were 54.29%, and 31.43% of the studied group have severe and moderate depression, while 37.14% of the control group have mild depression and 51.43 % of them have moderate depression.
There was a marked improvement in functioning impairment at the three domains with highly statistically statistically significant differences between pre- immediate post and follow-up programs for the studied group (p. value <0.001**).
There were highly statistically significant differences between the studied and control groups in pre-program intervention for a total score of depression, quality of life, and function impairment (p= 0.000).
There was a highly statistically significant difference in the quality of life and function impairment pre, post and follow up program regarding the studied group (p. value <0.001**), and there was no statistical difference regarding the control group in pre and follow up for the quality of life and function impairment (p. value <0.0291, 0.714) respectively.
Based on the findings of the present study, the following recommendations are suggested:
The family and home health care providers should be involved in the treatment process, to enhance psychosocial functioning and maintain the effectiveness of the program to reduce symptoms of depression.
Psychosocial interventions are needed to be delivered in out-patient settings and follow up for intensive improving social functioning in people with depressive disorders.
In the future psychosocial program should be continued during the three months and after following up to enhance the effect of program on the individuals with depressive disorder.