The influence of cognitive variables on recovery in depressed inpatients

Forty two unipolar depressed inpatients were assessed on admission to hospital and again two years after the onset of the index episode. Fifty seven per cent of the sample (n = 24) fulfilled NIMH recovery criteria within this period. Older age, female gender, severity of index episode, median prior duration of episode, higher levels of dysfunctional attitudes and low self-esteem significantly predicted chronicity of depression. Backward stepwise logistic regression identified that three of these variables measured at the time of admission: severity of index depression, higher levels of dysfunctional attitudes related to the need for approval, and low self-esteem provided a robust logistic model for predicting outcome. However, the small sample size and statistical analysis employed means that replication of our research is required. Larger scale studies could also include a factor analysis so that the common elements within the different instruments may be detected. If the association between cognitive dysfunction and chronicity is confirmed, we would recommend that inpatient treatment strategies are revised to incorporate more overt psychosocial interventions. (C) 1997 Elsevier Science B.V.