Response styles to depressed mood affect the long-term course of psychosocial functioning in depressed patients

Components of psychosocial functioning represent both relevant mental health outcomes and predictors for the further course of illness in patients with depression and other mental illnesses. Determinants of these outcomes beyond residual symptom levels have rarely been investigated. The present study aimed at investigating prospective effects of demographic variables, depression levels, and response styles to depressed mood on future psychosocial functioning outcomes in depressed patients.

We followed up a sample of unipolar depressed inpatients (n=71) one, six, 42, and 66 months after hospital discharge. At each measuring point, patients were assessed with regard to diagnostic status, symptom levels, response styles, subjective quality of life (QoL), and interviewer-rated social and occupational functioning. Longitudinal data were analyzed using time-lagged linear models.

Controlled for age, sex, and concurrent depression levels, higher symptom-focused rumination predicted lower future QoL in the psychological domain and lower social and occupational functioning. In parallel, higher levels of habitual distraction predicted higher future QoL in the psychological domain. Effects were comparable for men and women.

Given that response styles to depressed mood appear not only to affect the course of depressive symptoms but also future psychosocial outcomes, it is of particular relevance to address these coping styles in psychological therapies for depression and high-risk groups. Future controlled intervention studies should investigate possible specific mechanisms of how response styles may affect psychosocial outcomes.