Psychological and biological differences among first-episode and recurrently depressed women during depression and recovery.

Abstract

Depression remains one of the most common mental health problems in the United States. Although the social, psychological, and physiological impact of recurrent depressive episodes have not been systematically studied, accumulating clinical evidence suggests that there is indeed a toll paid for experiencing recurrent depression. The purpose of this study was to describe the psychological and neuroendocrine differences between women who had experienced only one episode of Major Depressive Disorder (FE) with women who had experienced recurrent depressive episodes (RD). Thirty-two depressed female clients from a large university medical center's outpatient clinic for depression were placed into first-episode (n = 14) and recurrent groups (n = 18), and were compared to a community sample of age-matched, female control subjects (n = 20). A battery of psychological instruments used to measure perceptions of control and helplessness, emotional responsiveness, interpersonal dependency, and self-appraisal and coping responses were administered while subjects were in an episode of depression, and again, when subjects were euthymic for at least a four week period (controls were measured at two time points, 8 to 12 weeks apart). Urinary-free cortisol measures for all groups were also completed at the same time points. Analyses using ANOVAs and paired t-tests have revealed significant differences in emotional responsiveness between first-episode and recurrently depressed groups during the episode of depression, and more importantly, after the depressive episode has resolved. Recovered, recurrently depressed women also endorsed a significantly greater number of items related to feeling a loss of control. Coping responses for the total depressed group were also significantly different than controls after recovery. Differences in urinary-free cortisol were not demonstrated. These findings suggest that experiencing recurrent episodes of depression may indeed have psychological consequences which may impact one's response to subsequent stressors. The development of a psychological sensitivity to depression is hypothesized.