Abstract
Background:A link between depression and insecure attachment has long been postulated. Although many studies examined the relationship between depressive symptoms and attachment, relatively few studies were performed on patients diagnosed with depression. Also, research on patients with bipolar disorder is scarce.Objective:We aimed at testing the association between attachment insecurity and unipolar and bipolar depression.Methods:We studied 21 patients with bipolar disorder, current episode depressed, and three age- and sex-matched groups, each consisting of 21 individuals: patients with major depressive disorder, recurrent episode; patients with epilepsy; non-clinical participants. The Experience in Close Relationships questionnaire was used to assess adult attachment style.Results:Patients with both bipolar and unipolar depression displayed significantly higher scores on attachment-related avoidance as compared with patients with epilepsy and non-clinical participants. Also, patients with bipolar depression scored significantly higher on attachment-related anxiety than all other groups. In both psychiatric groups, attachment dimensions were not significantly correlated with global clinical severity or severity of depression.Conclusion:Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression. Attachment theory may provide a valuable theoretical framework for future research and for guiding treatment.
Highlights
Depression is a major public health concern
Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression
Tukey’s post hoc test revealed that both patients with bipolar depression and recurrent major depression scored significantly higher (p
Summary
Depression is a major public health concern. A variety of biological, social, and psychological factors contribute to the development of depression [3 - 5]. 144 Clinical Practice & Epidemiology in Mental Health, 2019, Volume 15 most consistently identified risk factors is family history. Studies using genetically informative designs reported both substantial heritability and significant environmental effects [6 - 8], which corroborates the view that family environment factors increase vulnerability to mood disorders. Attachment plays a major part in the development of emotion regulation [9] and models of self [10], and there are important links between depression, dysfunctional emotion regulation [11], and dysfunctional schemas about the self [12].
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