Dependency, matching adversities, length of survival and relapse in major depression

This paper reports the 1-year follow-up of a sample of depressed patients. Social cognitive variables obtained during the index episode, including ideal emotional support, roles and goals investment in various domains and dysfunctional attitudes were used to predict subjects' likelihood for subsequent relapse. More subjects who experienced severe life events in the year were found to have relapsed. However, the predictive value of life events was improved if adversity was in the most invested domain according to the roles and goals questionnaire that subjects filled in during their index episode (matching adversity). Subjects who experienced matching adversity had a 3-fold chance of relapse compared with subjects with nonmatching adversity. The majority of the matching events were in the interpersonal domain. Levels of dysfunctional attitudes alone did not predict relapse. However, matching adversity and the dependency subscale of the dysfunctional attitude scale contributed significantly both to whether or not subjects relapsed and to the number of weeks subjects survived before they relapsed. The higher the level of dependency dysfunctional attitudes, the sooner subjects relapsed. The findings of the follow-up study supported the importance of psychological and social factors in determining relapse.