Clinical and personal recovery in depression across different recovery phases - A cross-sectional study

Recovery in depression is increasingly understood as a multimodal process encompassing not only symptom reduction i.e. clinical recovery but also personal recovery. However, research has focused mainly on personal recovery in samples with SMI. How clinical and personal recovery present across different recovery phases in depression remains unclear.

This study examined the association between clinical and personal recovery across recovery phases and explored differentiation between intra- and interpersonal domains of personal recovery across these phases among individuals with lived experience of depression.

A cross-sectional survey study was conducted among 159 participants with (a history of) depression. Clinical recovery was assessed with the Patient Health Questionnaire-9 (PHQ-9), personal recovery with the Individual Recovery Outcome Counter (I.ROC), and recovery phase with Stages of Recovery Instrument (STORI-30). Data were analyzed using multiple regression and ANCOVA.

Higher clinical recovery was strongly associated with higher personal recovery and explained 60% of its variance. While the cross-sectional design limits understanding of temporal aspects, both clinical and personal recovery scored lower in individuals in earlier compared to later recovery phases, with the bigger contrast between the first ('Moratorium') and subsequent four phases. In individuals in later recovery phases, interpersonal aspects of personal recovery were more pronounced compared to intrapersonal aspects.

Clinical and personal recovery are strongly associated in depression, which might be explained by overlapping constructs such as hope and identity. We hypothesize from these early findings that recovery unfolds in phases, with depressive symptoms and key intrapersonal factors improving in earlier phases, and interpersonal factors (e.g social contacts, activities) in later phases. Longitudinal research should further examine recovery across proposed phases in depression.