Modeling relapse in unipolar depression: the effects of dysfunctional cognitions and personality disorders

Survival analytic models were used to determine the effects of Axis II pathology and dysfunctional cognitions on depressive relapse in a sample of 50 depressed inpatients followed 33 to 84 months (M = 49.9) postdischarge. In analyses based on follow-up interview measures, expected remission duration among patients without personality disorders was approximately 7.4 times longer than among patients with Axis II comorbidity. Attributional style also accounted for unique variance in the relapse model, with adaptive positive event attributions inversely related to relapse probability. Neither dysfunctional attitudes nor negative event attributions were significantly related to relapse. Dimensional Axis II Cluster B and C pathology ratings were associated with decreased survival time, whereas Cluster A pathology was associated with increased survival. Among measures obtained during index hospitalization, only the dimensional rating of Axis II pathology was significantly predictive, with a cumulative 8% decrease in expected survival for each Axis II criterion item met.