Cognitive Reactivity Versus Dysfunctional Cognitions and the Prediction of Relapse in Recurrent Major Depressive Disorder

• DOI: 10.4088/jcp.14m09268
• Publication Date: 2015-08-27T15:29:51Z
• Authors: Caroline A. Figueroa; Henricus G. Ruhé; Maarten W. Koeter; Philip Spinhoven; Willem Van der Does; Claudi L. Bockting; Aart H. Schene
• Keywords: Dysfunctional family; Depression

Major depressive disorder (MDD) is a burdensome disease that has high risk of relapse/recurrence. Cognitive reactivity appears to be factor for relapse. It remains unclear, however, whether dysfunctional cognitions alone or the such mild states sadness (ie, cognitive reactivity) crucial increases relapse risk. We aimed assess long-term predictive value versus and other factors relapse.In prospective cohort outpatients (N = 116; studied between 2000-2005) who had experienced ≥ 2 previous major episodes (MDEs) were in remission (DSM-IV) at start follow-up, we measured reactivity, with Leiden Index Depression Sensitivity (LEIDS), cognitions, Dysfunctional Attitudes Scale, simultaneously. Course illness (with primary outcome MDE assessed by Structured Clinical Interview DSM-IV Axis I Disorders Patient Edition) time monitored prospectively 3.5 years.Cognitive scores associated over 3.5-year follow-up also when corrected number MDEs concurrent symptoms (hazard ratio 1 standard deviation [(HR(SD)); 20 points LEIDS, measuring reactivity] 1.47; 95% CI, 1.04-2.09; P .031). Rumination appeared particularly strong predictor (HR(SD) 1.60; 1.13-2.26; .007). did not predict years 1.00; 0.74-1.37; .93). Every 20-point increase on scale resulted 10% 15% (corrected symptoms).Cognitive reactivity--and rumination--is Future research should address psychological interventions can improve thereby prevent relapses.ISRCTN Identifier: 68246470.