Am J Psychiatry 1996; 153:1021-1027
Copyright © 1996 by American Psychiatric Association
Gender, type of treatment, dysfunctional attitudes, social support, life events, and depressive symptoms over naturalistic follow-up
C Zlotnick, MT Shea, PA Pilkonis, I Elkin and C Ryan
Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02906, USA.
OBJECTIVE: The present study investigated gender differences in depressive
symptoms during a naturalistic follow-up for outpatients with major
depressive disorder in the National Institute of Mental Health Treatment of
Depression Collaborative Research Program. Specifically, the study
investigated whether gender interacted with type of treatment received,
dysfunctional attitudes, life events, or social support to predict severity
of depressive symptoms. In addition, aspects of these psychosocial factors
(need for approval, interpersonal life events, and close friendships),
hypothesized to be more salient for women, were examined to determine if
they had a differential impact on level of depressive symptoms in men and
women. METHOD: Assessments conducted 6, 12, and 18 months after treatment
included measures of depressive symptoms, dysfunctional attitudes, current
life events, and social support. Data were available for 188 subjects (134
women and 54 men). Regression analyses were conducted to examine whether
gender as a main effect, or interacting with dysfunctional attitudes, life
events, social support, or subtypes of these variables, predicted cross-
sectional or longitudinal measures of depressive symptoms during follow-
up. RESULTS: A consistent finding of the study was that over the 18 months
of this naturalistic follow-up, there were no main effects for gender or
any significant interactions involving gender and any of the variables of
interest. The study demonstrated that life events and social support were
related to severity of depressive symptoms for both genders. CONCLUSIONS:
Despite differential prevalence rates of major depression for men and
women, findings do not support a different process in outcome of illness
for men and women.