Community participation as a predictor of depressive symptoms among individuals with serious mental illnesses

Background: People with serious mental illnesses have elevated levels of depressive symptoms. Limited engagement in meaningful activities, such as work, social interactions, volunteering, and participation in faith, are one plausible explanation for this. Increased community participation over time may be associated with decreased depressive symptoms. Aim: Examine whether an increase in participation over time predicts a decrease in depression after controlling for depression at the baseline. Methods: Participants were 183 adults with schizophrenia spectrum, bipolar disorder, or major depressive disorder who completed the Hopkins Symptom Index – Depression subscale and the Temple University Community Participation Measure. Participants completed these measures at baseline and either a 12- or 24-month follow-up timepoint. Multiple regression analyses were conducted with the depression score as a dependent variable and changes in community participation as a predictor variable. Demographics, baseline depression score, and time interval between baseline and last observation were entered as control variables. Results: Endorsing more activities as important, participating in more important areas that are important, and participating ‘enough’ in more important areas over time were each significant predictors of decreases in depression. Conclusion: These findings enhance the connection between community participation and depression and suggest that a focus on participation may be important in terms of boosting both community functioning and treatment goals.