title: Is nonverbal behavior in patients and interviewers relevant to the assessment of depression and its recovery? A study with Dutch and Brazilian patients.
abstract: Nonverbal behaviors exhibited by patients with depression in their interactions with others may reflect social maladjustment and depression maintenance. Investigations of associations between unipolar depression and both patients' and interviewers' behaviors have been scarce and restricted to European samples. This study examined whether nonverbal behavior in patients and their interviewers is associated with depression severity and recovery. Cultural differences were explored. Seventy-eight depressed outpatients (28 Brazilians, 50 Dutch) were evaluated before and after 8-week pharmacological treatment. Patients were videotaped during the Hamilton Depression Scale interview before treatment, and the Brazilians were also videotaped after treatment. Nonverbal behaviors (patients' speaking effort and interviewers' encouragement) were analyzed using a two-factor ethogram. Results revealed that speaking effort was associated with encouragement and both are not influenced by baseline depression severity. However, from before to after treatment, whereas encouragement remained unchanged, speaking effort increased among unrecovered patients. Speaking effort was associated with patients' culture: Brazilians exhibited higher speaking effort than Dutch. These findings highlight that whereas the supportive nonverbal behavior of the interviewer may be stable, the set of nonverbal behaviors composed by head movements, eye contact and gestures displayed by the patients during their speaking in clinical interviews reflects depression persistence after treatment.
authors.affiliation: Laboratory of Medical Investigation (LIM 23), Institute and Department of Psychiatry, University of São Paulo, Dr. Ovídio Pires de Campos street, 785 (ground floor). Postal Code: 01060-970, São Paulo, SP, Brazil. Electronic address: jufiquer@gmail.com.
authors.forename: Juliana Teixeira
authors.initials: JT
authors.lastname: Fiquer
authors.affiliation: Mood Disorders Unit (GRUDA), Institute and Department of Psychiatry, University of São Paulo, Dr. Ovídio Pires de Campos street, 785 (third floor). Postal Code: 01060-970, São Paulo, SP, Brazil.
authors.forename: Ricardo Alberto
authors.initials: RA
authors.lastname: Moreno
authors.affiliation: Mood Disorders Unit (GRUDA), Institute and Department of Psychiatry, University of São Paulo, Dr. Ovídio Pires de Campos street, 785 (third floor). Postal Code: 01060-970, São Paulo, SP, Brazil.
authors.forename: Janette Z
authors.initials: JZ
authors.lastname: Canales
authors.affiliation: Mood Disorders Unit (GRUDA), Institute and Department of Psychiatry, University of São Paulo, Dr. Ovídio Pires de Campos street, 785 (third floor). Postal Code: 01060-970, São Paulo, SP, Brazil.
authors.forename: Andre
authors.initials: A
authors.lastname: Cavalcanti
authors.affiliation: Laboratory of Medical Investigation (LIM 23), Institute and Department of Psychiatry, University of São Paulo, Dr. Ovídio Pires de Campos street, 785 (ground floor). Postal Code: 01060-970, São Paulo, SP, Brazil; Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 - Armando Salles Oliveira University City. Postal Code: 05508-900, São Paulo, SP, Brazil.
authors.forename: Clarice
authors.initials: C
authors.lastname: Gorenstein
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001938:Brazil; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005006:Ethnicity; D005260:Female; D005868:Gestures; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009633:Nonverbal Communication; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Culture; Depression persistence; Ethogram; Speaking effort; Unipolar depression