Risk for recurrence in depression
Section snippets
Definitions and methodological issues
Due to the fact that several different approaches have been taken to define both “depression” and “recurrence,” it is important to understand how these terms have been defined and what the methodological implications are of the different approaches adopted by investigators when studying recurrent depression.
Demographics
Considerable research on risk factors for recurrent depression has focused on demographic variables. These include gender, socio-economic status, and marital status. Generally, these variables have been considered risk factors for recurrence when they are more likely to be present in those with multiple episodes of depression, as opposed to those with only one episode or those with no history of depression.
Clinical picture and family history
Several clinical features of depression have been investigated to see if they explain risk for recurrence. These factors include age at onset of the first episode, lifetime number of depressive episodes, severity of first episode, presence of comorbid psychopathology, and family history of depression and other mental illness. Research in this area has not investigated the impact of DSM- or ICD-defined depressive subtypes, such as the melancholic subtype, on risk for recurrence, although this
Cognitions
Negative cognitive styles have long been implicated as a risk factor for the onset of depression. For example, it has been posited that individuals who attribute global, stable, and internal causes to stressful life events are more likely to become depressed than are those that attribute the causes to temporary, stable, and external influences (Abramson, Seligman, & Teasdale, 1978). Similarly, Beck hypothesized that those with dysfunctional beliefs and resulting negative cognitive biases would
Scar theories: an explanatory mechanism for elevated recurrence risk
Due to the greater rates of depression in those who have a history of depression compared to those who have no such history, it must be the case that either the depression itself somehow increases the vulnerability to become depressed again, or that individuals at high risk for multiple episodes already possessed the necessary characteristics to make them prone to depression even before their first episode. Scar theories focus on the former of these suppositions and are all similar in that they
Summary and conclusions
Depression is a very common mental illness that is highly recurrent in individuals. In addition, it is a disorder with substantial personal and public health consequences. Thus, there is great interest in the development of strategies that might reduce the recurrence of depression. Important to the development of preventive interventions is a basic understanding of the factors that predict and contribute to recurrence. However, research in this area is rife with methodological variability.
References (120)
- et al.
Childhood psychopathology retrospectively assessed among adults with early onset major depression
Journal of Affective Disorders
(1994) - et al.
Risk factors for depression at 12-month follow-up in adult primary health care patients with major depression: An international prospective study
Journal of Affective Disorders
(2003) - et al.
Clinical presentation and course of depression in youth: Does onset in childhood differ from onset in adolescence?
Journal of the American Academy of Child and Adolescent Psychiatry
(2004) - et al.
Cognitive, physiological, and personality correlates of recurrence of depression
Journal of Affective Disorders
(2005) - et al.
Neuroticism: A vulnerability marker for depression evidence from a family study
Journal of Affective Disorders
(1995) - et al.
The course of depression in individuals at high and low cognitive risk for depression: A prospective study
Journal of Affective Disorders
(2006) - et al.
Depressive spectrum disorders in high-risk adolescents: Episode duration and predictors of time to recovery
Journal of the American Academy of Child and Adolescent Psychiatry
(2002) - et al.
Predictors of recurrence in affective disorder — Analyses accounting for individual heterogeneity
Journal of Affective Disorders
(2000) - et al.
Sex and depression in the National Comorbidity Survey I: Lifetime prevalence, chronicity, and recurrence
Journal of Affective Disorders
(1993) - et al.
Prevalence, correlates and course of minor depression and major depression in the national comorbidity survey
Journal of Affective Disorders
(1997)
Age of onset in chronic major depression: Relations to demographic and clinical variables, family history, and treatment response
Journal of Affective Disorders
Gender and the course of major depressive disorder through adolescence in clinically referred youngsters
Journal of the American Academy of Child and Adolescent Psychiatry
Developmental changes in the phenomenology of depression in girls compared to boys from childhood onward
Journal of Affective Disorders
The interaction of drug- and psycho-therapy in the long-term treatment of depression
Journal of Affective Disorders
Major depression in community adolescents: Age at onset, episode duration, and time to recurrence
Journal of the Academy of Child and Adolescent Psychiatry
Severity of stressful life events in first and subsequent episodes of depression: The relevance of depressive subtype
Journal of Affective Disorders
Remission onset and relapse in depression: An 18-month prospective study of course for 100 first admission patients
Journal of Affective Disorders
Continuity of depression during the transition to adulthood: A 5-year longitudinal study of young women
Journal of the American Academy of Child and Adolescent Psychiatry
Unipolar depression in adolescents: Clinical outcome in adulthood
Journal of the American Academy of Child and Adolescent Psychiatry
Challenges in preventing relapse in major depression: Report of a National Institute of Mental Health Workshop on state of the science of relapse prevention in major depression
Journal of Affective Disorders
Learned helplessness in humans: Critiques and reformulation
Journal of Abnormal Psychology
Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression
Journal of Abnormal Psychology
Improving depression outcome: New concepts, strategies and technologies
Journal of Psychopharmacology
Diagnostic and statistical manual of mental disorders
Diagnostic and statistical manual of mental disorders
Diagnostic and statistical manual of mental disorders
Diagnostic and statistical manual of mental disorders
Cognitive therapy of depression
Beck depression inventory — II
Relapse after recovery from unipolar depression: A critical review
Psychological Bulletin
Genetic mediation of the relationship between social support and psychological well-being
Psychology and Aging
Personality and clinical predictors of recurrence of depression
Psychiatric Services
Course and outcome of child and adolescent major depressive disorder
Child and Adolescent Psychiatric Clinics of North America
Recurrent and nonrecurrent depression
Archives of General Psychiatry
Preventing relapse/recurrence in recurrent depression with cognitive therapy: A randomized controlled trial
Journal of Consulting and Clinical Psychology
Predicting the short-term outcome of first episodes and recurrences of clinical depression: A prospective study of life events, difficulties, and social support networks
Journal of Clinical Psychiatry
Adolescent twins discordant for major depressive disorder: Shared familial liability to externalizing and other internalizing disorders
Journal of Child Psychology and Psychiatry
Abnormal psychology
Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene
Science
Predictors of relapse into major depressive disorder in a nonclinical population
American Journal of Psychiatry
Predicting the long-term outcome of affective disorders
Acta Psychiatrica Scandinavica
Neurobehavioral aspects of affective disorders
Annual Review of Psychology
The psychometric characteristics of the Hamilton Depression Inventory
Journal of Personality Assessment
Personality dimensions and depression: Review and commentary
Canadian Journal of Psychiatry
Neuroticism, major depression and gender: A population-based twin study
Psychological Medicine
Diagnostic criteria for use in psychiatric research
Archives of General Psychiatry
The Maudsley long-term follow-up of child and adolescent depression: I. Psychiatric outcomes in adulthood
British Journal of Psychiatry
The Maudsley long-term follow-up of child and adolescent depression: II. Suicidality, criminality, and social dysfunction in adulthood
British Journal of Psychiatry
Conceptualization and rationale for consensus definitions of terms in major depressive disorder
Archives of General Psychiatry
Clinical predictors of recurrence in depression
American Journal of Psychiatry
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