Primary Care Companion J Clin Psychiatry 2002;4:202-206
© Copyright 2014 Physicians Postgraduate Press, Inc.
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In this study, the extent of interpersonal dysfunction
in depressed women was examined, and their degree of independence
of current depressive episodes or symptoms was
Using a variety of indices of interpersonal
behavior and beliefs, 812 community-dwelling women who
were formerly, currently, or never depressed were compared.
The spouses and adolescent children of these women, as well as
raters, also provided information. The study controlled for current
depressive mood and sociodemographic factors that could
affect social functioning. Results:
Formerly depressed but not
currently depressed women showed significantly more impairment
than never-depressed women on nearly all measures of
interpersonal dysfunction, a finding consistent with hypotheses
that interpersonal difficulties are not merely consequences of
depressive symptoms. Women who had formerly been depressed
were less likely to be stably married, had less marital
satisfaction, were more likely to experience spouse coercion
and physical injury, had more problematic relationships with
children and extended family members as well as friends, reported
more stressful life events that had interpersonal and conflict
content, and had greater insecurity in their beliefs about
other people. The spouses and boyfriends of these women reported
more problems as well, and they were more likely to
have diagnosable disorders. No between-group differences
were found, however, in children’s perceptions of warmth or
hostility on the part of the mothers. Limitations:
about the causal direction of the relationship between depressive
symptoms and interpersonal difficulties are precluded by
the cross-sectional design of this study. Clinical depression is
usually followed by subthreshold symptoms not identified by
standard diagnostic instruments; these symptoms are difficult to
distinguish from preceding or co-occurring interpersonal problems.
Interpersonal difficulties are a stable feature
of depression. They pose a great challenge to treatment, and
they may reflect an underlying susceptibility to both the onset
and recurrence of depression.