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

Published online by Cambridge University Press:  23 March 2020

K. Riihimäki ,
M. Vuorilehto ,
P. Jylhä  and
E. Isometsä
K. Riihimäki
Affiliation:
Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland Health Care and Social Services, City of Järvenpää, PL 41, 04401Järvenpää, Finland
M. Vuorilehto
Affiliation:
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
P. Jylhä
Affiliation:
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
E. Isometsä*
Affiliation:
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
*
⁎ Corresponding author at: Department of Psychiatry, Faculty of Medicine, University of Helsinki, P.O. Box 22, 00014 Helsinki, Finland. Tel.: +358 9 471 63728; fax: +358 9 471 63735. E-mail address:erkki.isometsa@hus.fi (E. Isometsä).
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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

DepressionResponse styleRuminationNeuroticismComorbidityPrimary care
Type
Original article
Information
European Psychiatry , Volume 33 , Issue 1 , March 2016 , pp. 1 - 8
Copyright
Copyright © European Psychiatric Association 2016

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