title: Differentiating early-onset chronic depression from episodic depression in terms of cognitive-behavioral and emotional avoidance.
abstract: BACKGROUND
  Although chronic depression is associated with lower global functioning and poorer treatment response than episodic depression, little is known about the differences between these two forms of depression in terms of psychological factors. Thus, the present study aimed at differentiating chronic and episodic depression regarding cognitive-behavioral and emotional avoidance that have been proposed as important risk factors for depression and promising targets for the treatment of depression.
  
  
  METHODS
  Thirty patients with early onset chronic depression were compared with 30 patients with episodic depression and 30 healthy, never-depressed controls in terms of self-reported cognitive-behavioral (social and non-social) and emotional avoidance.
  
  
  RESULTS
  Chronically depressed patients reported more avoidance than healthy controls in each of the measures. Moreover, they reported more cognitive-nonsocial and behavioral-nonsocial as well as behavioral-social and emotional avoidance (in the form of restricted emotional expression to others) than patients with episodic depression. This kind of emotional avoidance also separated best between chronically and episodically depressed patients. Furthermore, general emotion avoidance and behavioral-social avoidance were positively correlated with levels of depression in chronically depressed patients.
  
  
  CONCLUSIONS
  The results are based on self-report data and should thus be interpreted with caution. Additionally, the cross-sectional design limits any causal conclusions.
  
  
  CONCLUSIONS
  The findings underscore the relevance of cognitive-behavioral and emotional avoidance in differentiating chronic from episodic depression and healthy controls and advocate a stronger focus on maladaptive avoidance processes in the treatment of chronic depression.
authors: Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: timo.brockmeyer@med.uni-heidelberg.de.
authors: Timo
authors: T
authors: Brockmeyer
authors: Institute of Clinical Psychology, Hospital Stuttgart, Prießnitzweg 24, 70374 Stuttgart, Germany; Department of Clinical Psychology, University of Tübingen, Schleichstr.4, 72076 Tübingen, Germany.
authors: Dominika
authors: D
authors: Kulessa
authors: Department of Clinical Psychology, University of Tübingen, Schleichstr.4, 72076 Tübingen, Germany.
authors: Martin
authors: M
authors: Hautzinger
authors: Center for Psychological Psychotherapy, University of Heidelberg, Hauptstrasse 47-51, 69117 Heidelberg, Germany.
authors: Hinrich
authors: H
authors: Bents
authors: Institute of Clinical Psychology, Hospital Stuttgart, Prießnitzweg 24, 70374 Stuttgart, Germany.
authors: Matthias
authors: M
authors: Backenstrass
mesh_terms: D000293:Adolescent; D000328:Adult; D001362:Avoidance Learning; D016022:Case-Control Studies; D002908:Chronic Disease; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D055815:Young Adult
keywords: Chronic depression; Cognitive-behavioral avoidance; Emotional avoidance; Episodic depression