Response style and severity and chronicity of depressive disorders in primary health care

K Riihimäki; M Vuorilehto; P Jylhä; E Isometsä

doi:10.1016/j.eurpsy.2015.12.002

Response style and severity and chronicity of depressive disorders in primary health care

Eur Psychiatry. 2016 Mar:33:1-8. doi: 10.1016/j.eurpsy.2015.12.002. Epub 2016 Feb 6.

Authors

K Riihimäki¹, M Vuorilehto², P Jylhä², E Isometsä³

Affiliations

¹ Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland; Health Care and Social Services, City of Järvenpää, PL 41, 04401 Järvenpää, Finland.
² Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O.Box 900, 00029 HUS, Helsinki, Finland.
³ Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O.Box 900, 00029 HUS, Helsinki, Finland. Electronic address: erkki.isometsa@hus.fi.

PMID: 26854983
DOI: 10.1016/j.eurpsy.2015.12.002

Abstract

Background: Response styles theory of depression postulates that rumination is a central factor in occurrence, severity and maintaining of depression. High neuroticism has been associated with tendency to ruminate. We investigated associations of response styles and neuroticism with severity and chronicity of depression in a primary care cohort study.

Methods: In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up with a graphic life chart enabling evaluation of the longitudinal course of episodes. Neuroticism was measured with the Eysenck Personality Inventory (EPI-Q). Response styles were investigated at five years using the Response Styles Questionnaire (RSQ-43).

Results: At five years, rumination correlated significantly with scores of Hamilton Depression Rating Scale (r=0.54), Beck Depression Inventory (r=0.61), Beck Anxiety Inventory (r=0.50), Beck Hopelessness Scale (r=0.51) and Neuroticism (r=0.58). Rumination correlated also with proportion of follow-up time spent depressed (r=0.38). In multivariate regression, high rumination was significantly predicted by current depressive symptoms and neuroticism, but not by anxiety symptoms or preceding duration of depressive episodes.

Conclusions: Among primary care patients with depression, rumination correlated with current severity of depressive symptoms, but the association with preceding episode duration remained uncertain. The association between neuroticism and rumination was strong. The findings are consistent with rumination as a state-related phenomenon, which is also strongly intertwined with traits predisposing to depression.

Keywords: Comorbidity; Depression; Neuroticism; Primary care; Response style; Rumination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / psychology
Anxiety Disorders / diagnosis
Depression / psychology
Depressive Disorder* / diagnosis
Depressive Disorder* / epidemiology
Depressive Disorder* / psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Finland / epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Neuroticism
Personality Inventory
Primary Health Care* / methods
Primary Health Care* / statistics & numerical data
Prospective Studies
Psychiatric Status Rating Scales
Random Allocation
Socioeconomic Factors
Statistics as Topic
Surveys and Questionnaires