Abstract
BackgroundStressful life events (SLE) may influence the illness course and outcome. This study aimed to characterize socio-demographic and clinical features of euthymic major depressive disorder (MDD) outpatients with SLE compared with those without.MethodsThe present sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients of whom 250 (39.8%) reported SLE and 378 (60.2%) did not.ResultsAfter univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Moreover, relative to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic features, report a higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to have a comorbid panic disorder, residual interepisodic symptoms, use previous psychiatric medications, and currently use of antidepressants. Having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE after regression analyses. Mediation analyses showed that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications.ConclusionHaving a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants is linked to a specific “at risk” profile characterized by the enhanced vulnerability to experience SLE.
Highlights
Stressful life events (SLE) may influence the illness course and outcome
Our aim was to test whether the effect of current antidepressants use on SLE was mediated by specific variables
In line with previous evidence (38) suggesting that the occurrence of SLE was higher and the associated perceived experience was more deleterious in suicidal patients, we found an association between SLE in the previous six months and family history of suicidal behavior
Summary
Stressful life events (SLE) may influence the illness course and outcome. Negative life events, which may have a prominent role in the development and clinical course of psychiatric disorders may be identified in various social/ environmental contexts (2) and may be commonly defined as: 1) maltreatment and violence; 2) loss events; 3) intrafamilial problems; 4) school and interpersonal problems (3, 4). These type of life events are usually associated with undesirable affective experiences exerting deleterious effects on the individual mental health and social/environmental adaption (4). Certain types of SLE such as involuntary occupation loss and marital separation may enhance suicide risk (6, 7), and influence the time to remission of major depressive disorder (MDD) (8) as well as substance use (9)
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