Prediction of Recurrence in Recurrent Depression and the Influence of Consecutive Episodes on Vulnerability for Depression: A 2-Year Prospective Study
J Clin Psychiatry 2006;67:747-755
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Depression is a recurring disease.
Identifying risk factors for recurrence is essential.
The purpose of this study was to identify factors
predictive of recurrence and to examine whether
previous depressive episodes influence vulnerability for
subsequent depression in a sample of remitted
recurrently depressed patients.
Method: Recurrence was examined
prospectively using the Structured Clinical Interview for
DSM-IV Axis I Disorders in 172 euthymic patients with
recurrent depression (DSM-IV) recruited from
February 2000 through September 2000. Illness-related
characteristics, coping, and stress (life events and
daily hassles) were examined as predictors.
Results: Risk factors for recurrence were a
high number of previous episodes, more residual
depressive symptomatology and psychopathology, and
more daily hassles. Factors with both an increasing
and decreasing pathogenic effect with increasing
episode number were detected.
Conclusion: We found some support for
dynamic vulnerability models that posit a change of
vulnerability with consecutive episodes. Preventive
interventions should be considered in patients with
multiple recurrences, focusing on residual symptomatology and specific coping styles.