Psychosocial and clinical predictors of symptom persistence vs remission in major depressive disorder.
OBJECTIVE
The present study evaluates the impact of a range of psychosocial factors on the outcome of major depression while controlling for the effect of clinical variables.


METHODS
Patients (n = 171) seen in consultation at a mood disorders clinic completed measures of neuroticism, rumination, coping style, sexual abuse history, and parental bonding experiences at Time 1 and completed measures of interpersonal and achievement life events and depression 12 months later.


RESULTS
In univariate analyses, neuroticism, rumination, interpersonal and achievement life events, and sexual abuse history were associated with nonremission, whereas avoidance coping was associated with remission at Time 2. Interpersonal and achievement life events and sexual abuse history were associated with nonimprovement, whereas avoidance coping was associated with improvement at Time 2. Significant predictors of both remission and improvement in logistic regression analyses controlling for clinical variables (depression and anxiety severity, duration of illness, and age) included avoidance, interpersonal life events, and the interaction between avoidance and interpersonal life events.


CONCLUSIONS
Interpersonal events and responses to depression (that is, coping) play an important role in the outcome of major depression. Further attention to coping style and interactions between psychological factors and life events is warranted in future research on depression persistence.
Enns
Murray W
MW
Department of Psychiatry, University of Manitoba, Winnipeg. menns@hsc.mb.ca
Cox
Brian J
BJ
D000124:Achievement; D000223:Adaptation, Psychological; D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D010287:Parent-Child Relations; D011584:Psychology; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors