The influence of an uncaring partner on the type and outcome of depression

We seek to clarify recent inconsistent research findings in relation to the Intimate Bond Measure (IBM), where low IBM care scores have been held to be over-represented in non-melancholic depression and to predict a poor depressive episode outcome.

A sample of 82 subjects meeting DSM criteria for a major depressive episode lasting less than 2 years, took part in a 1-year follow-up study. The IBM was completed at initial assessment and depression severity assessed at baseline and at follow-up assessment, allowing a measure of "outcome".

A significantly greater proportion of DSM-defined non-melancholic than melancholic depressives perceived their partner as providing deficient care and were classified as being in a dysfunctional relationship, seemingly unrelated to demographic differences or by depression severity, chronicity or recurrence. IBM scores were again established as independent of a number of putative distorting influences, such as depression severity and "neuroticism". Although the IBM failed to significantly predict outcome, there was a clear trend for greater improvement in those in IBM care score-defined "functional relationships".

The study failed to assess the change in patients' perceptions of care over time, which may have contributed to the failure to replicate past findings in relation to outcome.

The significance of examining the relevance of psychosocial factors such as deficient intimacy to separate depressive sub-types is highlighted. Implications of these findings for clinical intervention and future research studies are discussed.