Personal and Psychosocial Risk Factors for Physical and Mental Health Outcomes and Course of Depression Among Depressed Patients

Department of Medicine, University of California, Los Angeles, Los Ángeles, California, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 07/1995; 63(3):345-55. DOI: 10.1037/0022-006X.63.3.345
Source: PubMed


This article focuses on personal and psychosocial factors to identify those that predict change in functioning and well-being and clinical course of depression in depressed outpatients over time. Data from 604 depressed patients in The Medical Outcomes Study showed improvements in measures of functioning and well-being associated with patients who were employed, drank less alcohol, and had active coping styles. Better clinical course of depression was associated with patients who had high levels of social support, who had more active and less avoidant coping styles, who were physically active, and who had fewer comorbid chronic conditions. Findings provide some guidance as to what can be done to improve depressed patients' levels of physical and mental health and affect the clinical course of depression.

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    • "Further, most research has employed depressive symptom severity rather than relapse as the dependent variable (e.g., Sherbourne et al., 1995). Thus, while the literature has demonstrated promising moves towards the development of complex models of depression, this literature remains in its infancy with respect to relapse (in Dobson and Dozois, 2008b). "
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    ABSTRACT: The present study evaluated an integrated model of the role of psychosocial factors in the prediction of relapse of Major Depressive Disorder over a one-year follow-up period. METHODS AND ANALYSES: A range of established variables, including life stress, cognitive-personality vulnerability factors, social support, and coping responses, were simultaneously considered in a series of prediction models, in an adult female sample of remitted depressed individuals. It was determined that interpersonal marked difficulties, social support, and emotion-oriented and avoidance-oriented coping provided the best-fitting and most parsimonious predictive model for depressive relapse at one-year follow-up. The examination of multifactorial models of risk represents a promising avenue for future research and theory development.
    Journal of Affective Disorders 12/2009; 124(1-2):60-7. DOI:10.1016/j.jad.2009.11.015 · 3.38 Impact Factor
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    • "These avoidance strategies were identified as psychological risk factors or marker for adverse responses to stressful life events [3]. Data from depressed patients showed that a better clinical course of depression was associated with patients who had high levels of social support, had more active and less avoidant coping styles, and who were physically active [4]. Lung transplant candidates most likely use active, acceptance, and support-seeking strategies to cope with health problems, while self-blame or avoidance were rarely used [5]; however, the avoidant coping was the most strongly and consistently related to quality of life. "
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    ABSTRACT: The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Due to the importance of this concept for the long-term course of disease, there is a strong interest to develop a tool to identify the levels and factors of acceptance. We thus intended to test an instrument designed to assess the level of positive psychological wellbeing and coping, particularly emotional disease acceptance and life satisfaction In an anonymous cross-sectional survey enrolling 115 patients (51% female, 49% male; mean age 47.6 +/- 10.0 years) with depression and/or alcohol addiction, the ERDA questionnaire was tested. Factor analysis of the 29-item construct (Cronbach's alpha = 0.933) revealed a 4-factor solution, which explained 59.4% of variance: (1) Positive Life Construction, Contentedness and Well-Being; (2) Conscious Dealing with Illness; (3) Rejection of an Irrational Dealing with Disease; (4) Disease Acceptance. Two factors could be ascribed to a rational, and two to an emotional acceptance. All factors correlated negatively with Depression and Escape, while several aspects of Life Satisfaction" (i.e. myself, overall life, where I live, and future prospects) correlated positively. The highest factor scores were found for the rational acceptance styles (i.e. Conscious Dealing with Illness; Disease Acceptance). Emotional acceptance styles were not valued in a state of depression. Escape from illness was the strongest predictor for several acceptance aspects, while life satisfaction was the most relevant predictor for "Positive Life Construction, Contentedness and Well-Being". The ERDA questionnaire was found to be a reliable and valid assessment of disease acceptance strategies in patients with depressive disorders and drug abuses. The results indicate the preferential use of rational acceptance styles even in depression. Disease acceptance should not be regarded as a coping style with an attitude of fatalistic resignation, but as a complex and active process of dealing with a chronic disease. One may assume that an emotional acceptance of disease will result in a therapeutic coping process associated with higher level of life satisfaction and overall quality of life.
    Health and Quality of Life Outcomes 02/2008; 6(4):4. DOI:10.1186/1477-7525-6-4 · 2.12 Impact Factor
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    • "Resultater er ligeledes fundet ved psykiske lidelser. Således har man haB gode resultater i behandlingen af leXe til moderate depressioner ved at inddrage ånde‑ lige aspekter (i stedet for at tabuisere dem) hos patienter, der har en tro (Propst et al., 1992, Sherbourne et al., 1995, Bosworth et al., 2003, Koenig et al., 1992, Koenig et al., 1998a, Boscaglia et al., 2005, Smith, 2003, Hintikka, 1998, Miller, 2002, Braam et al., 1997, Berry, 2002). Den dynamik, som troen og ikke mindst det håb, troen og kaerligheden indebaerer, lader til at vaere en vigtig ressource for patienter med psy‑ kiske lidelser (Koenig et al., 2001b, Pargament et al., 2004, Abernethy et al., 2002, Ross, 1990, Cheng‑Yi Hahn, 2004, Wink and Dillon, 2003, Townsend et al., 2002). "

    01/2007; 7(6):97-127.
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