IMPACT OF REHABILITATION PROTOCOLS ON FUNCTIONAL RECOVERY AFTER MAJOR ORTHOPEDIC TRAUMA

Abstract

The Major Depressive Disorder (MDD) is one of the heterogeneous psychiatric disorders characterized by a wide range of syndromic severity and functional deficiency. This paper aimed at examining the interaction of neurobiological, psychological and social determinants on the severity of the Major Depressive Disorder (MDD) in an integrative biopsychosocial model. The study used a mixed-method analytical model to evaluate the connections between biological indicators (neurochemical dysregulation, stress-response activity and inflammatory markers) and psychological ones (cognitive distortions, emotional regulation ability, and comorbid symptom profiles) and social factors (social support, socioeconomic stressors, and interpersonal functioning) and measured depressive severity. The results revealed that neurobiological dysregulation was strongly associated with the intensity of symptoms at the baseline, but the psychological factors were highly mediated with each other and made the severity of depression worse. Social determinants were also found to be important contextual moderators, and reduced social support and increased chronic stress predicted more serious and persistent depressive symptoms. The multivariate analyses revealed that individuals that had experienced cumulative risk in all the three areas were most severely depressed, most functionally impaired, and exhibited persistent symptoms. These results are supportive of an integrated biopsychosocial model of MDD severity and the deficiencies of methods that focus on the individual-domain accounts. The research demonstrates the level of significance of applying multidimensional assessment and integrative treatment plans using personalized approaches, to successfully treat severe depression. This study clarifies how biological vulnerability, psychological processes, and social factors contribute to the degree of depression and thus gives a deeper and more practical insight into Major Depressive Disorder.