Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through intervention. Here, we examined resilience during a 3-month period as patients experienced their first episode of major depressive disorder (MDD). We hypothesized that despite MDD, resilient people could recover from depressive states more quickly than less resilient people. Methods: Twelve patients experienced their first MDD episode and 21 healthy control individuals participated in the study. Data from the Hamilton Depression Rating Scale (HAM-D), S-H Resilience Scale (S-HRS), and State-Trait Anxiety Index (STAI) were collected at two time points. Time 1 was the first visit after registration and Time 2 was 12 weeks later. Based on the symptoms described by the HAM-D results, the MDD group was divided into MDD-remission and MDD-residual subgroups. Results: Compared with controls, patients showed significantly lower resilience (low scores for Factor-A, Factor-B, and total S-HRS). Moreover, total SHRS scores for the MDD-remission group increased significantly from the Time 1 to Time 2, while those in MDD-residual group did not change. No significant differences in STAI scores were observed between MDD-remission and MDD-residual groups at either time point. Conclusion: This is the first report to show that patients experiencing their first episode of MDD show low resilience, and that a resilience scale might be a good index for estimating recovery from depression.
References
[1]
Kessler, R.C., Berglund, P., Demler, O., Jin, R. and Walters, E.E. (2005) Lifetime Prevalence and Age-of-Onset Distributions’ of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-602. https://doi.org/10.1001/archpsyc.62.6.593
[2]
Ferrari, A.J., Charlson, F.J., Norman, R.E., et al. (2013) Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLoS Medicine, 10, e1001547. https://doi.org/10.1371/journal.pmed.1001547
[3]
Rush, A.J., Trivedi, M.H., Wisniewski, S.R., et al. (2006) Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report. The American Journal of Psychiatry, 163, 1905-1917. https://doi.org/10.1176/ajp.2006.163.11.1905
[4]
Harald, B. and Gordon, P. (2012) Meta-Review of Depressive Subtyping Models. Journal of Affective Disorders, 139, 126-140. https://doi.org/10.1016/j.jad.2011.07.015
[5]
Fried, E.I., Nesse, R.M., Zivin, K., Guille, C. and Sen, S. (2014) Depression Is More than the Sum Score of Its Parts: Individual DSM Symptoms Have Different Risk Factors. Psychological Medicine, 44, 2067-2076. https://doi.org/10.1017/S0033291713002900
[6]
Kendler, K.S., Aggen, S.H. and Neale, M.C. (2013) Evidence for Multiple Genetic Factors Underlying DSM-IV Criteria for Major Depression. JAMA Psychiatry, 70, 599-607. https://doi.org/10.1001/jamapsychiatry.2013.751
Kendler, K.S., Hettema, J.M., Butera, F., Gardner, C.O. and Prescott, C.A. (2003) Life Event Dimensions of Loss, Humiliation, Entrapment, and Danger in the Prediction of Onsets of Major Depression and Generalized Anxiety. Archives of General Psychiatry, 60, 789-796. https://doi.org/10.1001/archpsyc.60.8.789
[9]
Lohoff, F.W. (2010) Overview of the Genetics of Major Depressive Disorder. Current Psychiatry Reports, 12, 539-546. https://doi.org/10.1007/s11920-010-0150-6
[10]
Wermelinger ávila, M.P., Lucchetti, A.L.G. and Lucchetti, G. (2017) Association between Depression and Resilience in Older Adults: A Systematic Review and Meta-Analysis. International Journal of Geriatric Psychiatry, 32, 237-246. https://doi.org/10.1002/gps.4619
[11]
Wells, M., Avers, D. and Brooks, G. (2012) Resilience, Physical Performance Measures, and Self-Perceived Physical and Mental Health in Older Catholic Nuns. Journal of Geriatric Physical Therapy, 35, 126-131. https://doi.org/10.1519/JPT.0b013e318237103f
[12]
Rutter, M. (1985) Resilience in the Face of Adversity. Protective Factors and Resistance to Psychiatric Disorder. The British Journal of Psychiatry, 147, 598-611. https://doi.org/10.1192/bjp.147.6.598
[13]
Fancourt, D., Perkins, R., Ascenso, S., et al. (2016) Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users. PLoS ONE, 11, e0151136. https://doi.org/10.1371/journal.pone.0151136
[14]
Alschuler, K.N., Kratz, A.L. and Ehde, D.M. (2016) Resilience and Vulnerability in Individuals with Chronic Pain and Physical Disability. Rehabilitation Psychology, 61, 7-18. https://doi.org/10.1037/rep0000055
[15]
Benight, C.C. and Bandura, A. (2004) Social Cognitive Theory of Posttraumatic Recovery: The Role of Perceived Self-Efficacy. Behaviour Research and Therapy, 42, 1129-1148.
[16]
Zimmerman, M., McGlinchey, J.B., Posternak, M.A., et al. (2006) How Should Remission from Depression Be Defined? The Depressed Patient’s Perspective. The American Journal of Psychiatry, 163, 148-150. https://doi.org/10.1176/appi.ajp.163.1.148
[17]
Hoge, E.A., Austin, E.D. and Pollack, M.H. (2007) Resilience: Research Evidence and Conceptual Considerations for Posttraumatic Stress Disorder. Depression and Anxiety, 24, 139-152. https://doi.org/10.1002/da.20175
[18]
Connor, K.M. (2006) Assessment of Resilience in the Aftermath of Trauma. The Journal of Clinical Psychiatry, 67, 46-49.
[19]
Shirotani, K., Nakano, A. and Saito, T. (2013) Role of Resilience in Recovery Process from Depressive State: A Study Subject to Patients in the Department of Psychosomatic Medicine. The Japanese Journal of Clinical Psychiatry, 42, 899-907. (In Japanese)
[20]
Seok, J.H., Lee, K.U., Kim, W., et al. (2012) Impact of Early-Life Stress and Resilience on Patients with Major Depressive Disorder. Yonsei Medical Journal, 53, 1093-1098. https://doi.org/10.3349/ymj.2012.53.6.1093
[21]
Silveira, P.P., Portella, A.K., da Silva Benetti, C., et al. (2011) Association between Na+, K+-ATPase Activity and the Vulnerability/Resilience to Mood Disorders Induced by Early Life Experience. Neurochemical Research, 36, 2075-2082. https://doi.org/10.1007/s11064-011-0531-1
[22]
Carli, V., Mandelli, L., Zaninotto, L., et al. (2011) A Protective Genetic Variant for Adverse Environments? The Role of Childhood Traumas and Serotonin Transporter Gene on Resilience and Depressive Severity in a High-Risk Population. European Psychiatry, 26, 471-478. https://doi.org/10.1016/j.eurpsy.2011.04.008
[23]
First, M.B., Spitzer, R.L., Gibbon, M., et al. (1995) The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Part II: Multi-Site Test-Retest Reliability Study. Journal of Personality Disorders, 9, 92-104. https://doi.org/10.1521/pedi.1995.9.2.92
[24]
First, M.B., Spitzer, R.L., Gibbon, M. and Williams, J.B. (2002) Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P) Biometrics Research, New York State Psychiatric Institute, New York.
[25]
Endicott, J., Cohen, J., Nee, J., Fleiss, J. and Sarantakos, S. (1981) Hamilton Depression Rating-Scale: Extracted from Regular and Change Versions of the Schedule for Affective-Disorders and Schizophrenia. Archives of General Psychiatry, 38, 98-103. https://doi.org/10.1001/archpsyc.1981.01780260100011
[26]
Hamilton, M. (1960) A Rating Scale for Depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56-62. https://doi.org/10.1136/jnnp.23.1.56
[27]
Windle, G., Bennett, K.M. and Noyes, J. (2011) A Methodological Review of Resilience Measurement Scales. Health and Quality of Life Outcomes, 9, 8. https://doi.org/10.1186/1477-7525-9-8
[28]
Sukemune, S. (2007) S-H Style Resilience Test. Takei Industrial Co. Ltd. (In Japanese)
[29]
Sato, T. and Sukemune, S. (2009) A Trail of Standarizing Resilience Scale—A Study of Development, Reliability, and Validity of “S-H Resilience Test (Part 1)”. The Japanese Nursing Research, 42, 5-52. (In Japanese)
[30]
Julian, L.J. (2011) Measures of Anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HA-DS-A). Arthritis Care & Research, 63, S467-S472. https://doi.org/10.1002/acr.20561
[31]
Bazin, N., Brunet-Gouet, E., Bourdet, C., et al. (2009) Quantitative Assessment of Attribution of Intentions to Others in Schizophrenia Using an Ecological Video-Based Task: A Comparison with Manic and Depressed Patients. Psychiatry Research, 167, 28-35. https://doi.org/10.1016/j.psychres.2007.12.010
[32]
Derntl, B. and Habel, U. (2011) Deficits in Social Cognition: A Marker for Psychiatric Disorders? European Archives of Psychiatry and Clinical Neuroscience, 26, 145. https://doi.org/10.1007/s00406-011-0244-0
[33]
Hirschfeld, R.M., Montgomery, S.A., Keller, M.B., et al. (2000) Social Functioning in Depression: A Review. The Journal of Clinical Psychiatry, 61, 268-275. https://doi.org/10.4088/JCP.v61n0405
[34]
Rhebergen, D., Beekman, A.T.F., de Graaf, R., et al. (2010) Trajectories of Recovery of Social and Physical Functioning in Major Depression, Dysthymic Disorder and Double Depression: A 3-Year Follow-Up. Journal of Affective Disorders, 124, 148-156. https://doi.org/10.1016/j.jad.2009.10.029
[35]
Rizvi, S.J., Cyriac, A., Grima, E., et al. (2015) Depression and Employment Status in Primary and Tertiary Care Settings. The Canadian Journal of Psychiatry, 60, 14-22. https://doi.org/10.1177/070674371506000105
[36]
Rehman, U.S., Gollan, J. and Mortimer, A.R. (2008) The Marital Context of Depression: Research, Limitations, and New Directions. Clinical Psychology Review, 28, 179-198.
[37]
Merikangas, K.R., Nakamura, E.F. and Kessler, R.C. (2009) Epidemiology of Mental Disorders in Children and Adolescents. Dialogues in Clinical Neuroscience, 11, 7-20.
[38]
Kessler, R.C., Chiu, W., Demler, O. and Walters, E.E. (2005) Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627. https://doi.org/10.1001/archpsyc.62.6.617
[39]
Scali, J., Gandubert, C., Ritchie, K., et al. (2012) Measuring Resilience in Adult Women Using the 10-Items Connor-Davidson Resilience Scale (CD-RISC). Role of Trauma Exposure and Anxiety Disorders. PLoS ONE, 7, e39879. https://doi.org/10.1371/journal.pone.0039879
[40]
Westphal, M. and Bonanno, G.A. (2007) Posttraumatic Growth and Resilience to Trauma: Different Sides of the Same Coin or Different Coins? Applied Psychology, 56, 417-427. https://doi.org/10.1111/j.1464-0597.2007.00298.x
