Psychosocial Stressor, Coping and Short Term Treatment Outcome of DSM-III-R Major Depression

Abstract

There have been many studies which suggest the psychosocial stressors impact on the progress of depression up to this point. We investigated the relationship between psychosocial stressors, coping, and three-month treatment outcome of DSM-III-R Major Depression. Subjects were 32 outpatients with Major Depression who were diagnosed by Structured Clinical Interview for DSM-III-R (SCID). They were followed up prospectively for four months and outcome was evaluated by the Hamilton Rating Scale for Depression based on the Frank's suggestion. For measurement of stressors and coping, the scale of Axis IV in DSM-III-R and the Time Ordered Stress and Health Interview were used, Our results indicated that patients who did not remit had experienced significantly more numbers of stressor during one-year before the entry than the remitted group (p<0. 05), but the degree of Axis-IV scale (DSM-III-R) was not related to outcome. Good three-month outcome group showed more cognitive coping (p<0. 05) and problem-solving (p<0. 10), whereas avoidant coping (p<0. 10) and wish for miracle (p<0. 05) were related to poor outcome. According to the discriminant analysis, the number of stressors (p<0. 05) and cognitive coping (p<0. Ol) had a strong influence on three-month outcome. We emphasize the importance of evaluating coping for stressful situations in case of investigating the relationship between a progress and psychosocial factors with depression, and hypothesizing the efficacy of therapeutic approach that might be able to change passive-avoidant coping into more positive-cognitive one.