The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms

Faculty of Behavioural Sciences, University of Helsinki, Helsinki, Uusimaa, Finland
Psychological Medicine (Impact Factor: 5.94). 07/2006; 36(6):779-88. DOI: 10.1017/S0033291706007276
Source: PubMed


Adverse life events and social support may influence the outcome of major depressive disorder (MDD). We hypothesized that outcome would depend on the level of depressive symptoms present at the outset, with those in partial remission being particularly vulnerable.
In the Vantaa Depression Study (VDS), patients with DSM-IV MDD were interviewed at baseline, and at 6 and 18 months. Life events were investigated with the Interview for Recent Life Events (IRLE) and social support with the Interview Measure of Social Relationships (IMSR) and the Perceived Social Support Scale - Revised (PSSS-R). The patients were divided into three subgroups at 6 months, those in full remission (n = 68), partial remission (n = 75) or major depressive episode (MDE) (n = 50). The influence of social support and negative life events during the next 12 months on the level of depressive symptoms, measured by the Hamilton Rating Scale for Depression (HAMD), was investigated at endpoint.
The severity of life events and perceived social support influenced the outcome of depression overall, even after adjusting for baseline level of depression and neuroticism. In the full remission subgroup, both severity of life events and subjective social support significantly predicted outcome. However, in the partial remission group, only the severity of events, and in the MDE group, the level of social support were significant predictors.
Adverse life events and/or poor perceived social support influence the medium-term outcome of all psychiatric patients with MDD. These factors appear to have the strongest predictive value in the subgroup of patients currently in full remission.

17 Reads
  • Source
    • "They would simply indicate vulnerability to depression. Some longitudinal studies also found that the severity of life events [28] influences the outcomes of depression. Some other studies have identified the number of daily hassles as potential risk factors for persistence [29] while other studies did not find any association [30] or in the multivariate model this effect disappeared [31]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to describe changes in depression and its correlates, in community-dwelling elderly, over a 12-month period. Data come from a longitudinal ESA Study (Enquête sur la Santé des Aînés) of elderly persons (n = 2752). Depression was measured using the DSM-IV criteria. Polytomous logistic regression was used to assess relations, over time, between participant's characteristics and depression. Among the 164 (5.9%) subjects, who were depressed at baseline, 19.5% were continuously ill cases and 80.4% had recovered, 12 months later. In polytomous regression, factors increasing the probability of the three depression states (persistence, recovery, and incidence) were daily hassles, stress intensity, and fair/poor self-rated mental health. Depression in old age is dynamic. Available prognostic factors can be taken into account to help direct treatment to elderly at highest risk of a poor prognosis.
    Depression research and treatment 03/2013; 2013(11):451708. DOI:10.1155/2013/451708
  • Source
    • "Much research in sociology (see Stack, 2000, for review) and psychology has reported on the beneficial effects of social support. Many psychological studies provide evidence that even the mere perceived availability of social support can have a direct beneficial effect on health and mood (Cobb, 1976; Cohen & Hoberman, 1983; Cohen & Wills, 1985; Leskelä et al., 2006; Nasser & Overholser, 2005; Nezlek & Allen, 2006; Paykel, Emms, Fletcher, & Rassaby, 1980). Recent studies showed that perceived social support may protect individuals from suicide risk (as operationalized by suicide ideation) conferred by impulsivity (Kleiman, Riskind, Shaefer, & Weingarden, in press) and stressful life events (Chioqueta & Stiles, 2007; Clum & Febbraro, 1994; Oyama et al., 2010; Yang & Clum, 1994; You, Van Orden, & Conner, 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: While perceived social support has received considerable research as a protective factor for suicide ideation, little attention has been given to the mechanisms that mediate its effects. Aims: We integrated two theoretical models, Joiner's (2005 ) interpersonal theory of suicide and Leary's ( Leary, Tambor, Terdal, & Downs, 1995 ) sociometer theory of self-esteem to investigate two hypothesized mechanisms, utilization of social support and self-esteem. Specifically, we hypothesized that individuals must utilize the social support they perceive that would result in increased self-esteem, which in turn buffers them from suicide ideation. Method: Participants were 172 college students who completed measures of social support, self-esteem, and suicide ideation. Results: Tests of simple mediation indicate that utilization of social support and self-esteem may each individually help to mediate the perceived social support/suicide ideation relationship. Additionally, a test of multiple mediators using bootstrapping supported the hypothesized multiple-mediator model. Limitations: The use of a cross-sectional design limited our ability to find true cause-and-effect relationships. Conclusion: Results suggested that utilized social support and self-esteem both operate as individual moderators in the social support/self-esteem relationship. Results further suggested, in a comprehensive model, that perceived social support buffers suicide ideation through utilization of social support and increases in self-esteem.
    Crisis The Journal of Crisis Intervention and Suicide Prevention 07/2012; 34(1):1-8. DOI:10.1027/0227-5910/a000159 · 1.09 Impact Factor
  • Source
    • "Consistent with previous research [30, 39], lower reported stress and higher perceived social support at baseline were related to lower depression severity after 3 months, and these mediators appeared to partially account for the association of religious factors with depression severity. These results are consistent with the hypothesis that attending religious worship provides one with more opportunities to receive community support, and also helps to reduce stress. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Psychiatric patients (age 59+) were assessed before study treatment for major depressive disorder, and again after 3 months. Measures taken before study treatment included facets of religiousness (subjective religiosity, private prayer, worship attendance, and religious media use), social support, and perceived stress. Clinician-rated depression severity was assessed both before and after treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Structural equation modeling was used to test a path model of direct and indirect effects of religious factors via psychosocial pathways. Subjective religiousness was directly related to worse initial MADRS, but indirectly related to better posttreatment MADRS via the pathway of more private prayer. Worship attendance was directly related to better initial MADRS, and indirectly related to better post-treatment MADRS via pathways of lower stress, more social support, and more private prayer. Private prayer was directly related to better post-treatment MADRS. Religious media use was related to more private prayer, but had no direct relationship with MADRS.
    Depression research and treatment 02/2012; 2012(5):745970. DOI:10.1155/2012/745970
Show more