Abstract
Objective: Little is known about the specific psychological features that differentiate persistent depressive disorder (PDD) and episodic depression (ED). Thus, the present study aimed to investigate differences in social cognition and interpersonal problems between these two forms of depression and healthy controls. In addition, we aimed to examine childhood maltreatment (CM) as a possible origin of these alterations.Methods: In a cross-sectional study, adult patients with a current PDD (n = 34) or in a current episode of ED (n = 38), and healthy controls (n = 39) completed questionnaires about depression severity, empathy, interpersonal problems, and CM, as well as tests of affective theory of mind and facial emotion recognition.Results: Patients with PDD reported higher empathic distress than patients with ED and healthy controls. Both depressive groups recognized angry faces with higher accuracy and reported more interpersonal problems, with no differences between PDD and ED. Empathic distress and interpersonal problems mediated the link between CM and depression in the combined sample.Limitations: Patient groups were not drug-naïve and antidepressant intake might have influenced social-cognitive functions. Self-report measures of empathy and interpersonal problems are vulnerable to bias. The cross-sectional design does not allow causal conclusions.Conclusion: Depressed patients may not show deficits in decoding the affective states of others and in feeling with others. However, depressed individuals—in particular patients with PDD—may feel easily overwhelmed by emotionally tense situations, resulting in empathic distress and avoidant/submissive interpersonal behavior. Exposure to CM might be an origin of alterations in social cognition and interpersonal problems.
Highlights
According to the DSM-5 diagnostic criteria, a persistent depressive disorder (PDD) is characterized by symptoms of depressed mood for at least 2 years [1]
PDD is associated with an earlier age of onset, higher rates of comorbid mental and somatic disorders, more frequent suicide attempts, and higher treatment resistance when compared with episodic depression (ED) [3]
Bonferroni-corrected post-hoc tests revealed that patients with PDD reported significantly more empathic distress compared to healthy controls and patients with ED
Summary
According to the DSM-5 diagnostic criteria, a persistent depressive disorder (PDD) is characterized by symptoms of depressed mood for at least 2 years [1]. 30% of depressed individuals develop a chronic course of the disorder, as defined by the PDD criteria [2]. PDD is associated with an earlier age of onset, higher rates of comorbid mental and somatic disorders, more frequent suicide attempts, and higher treatment resistance when compared with episodic depression (ED) [3]. Since approximately 75–80% of chronically depressed patients were exposed to at least moderate to severe childhood maltreatment (CM) [4], exposure to abuse and neglect in childhood is assumed to be a major risk factor for the development of PDD. Studies comparing the prevalence of CM in PDD and ED are rare and resulted in inconsistent findings [3, 6, 7]
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