Course and chronicity of unipolar major depressive disorder: Commentary onJoiner

Authors
Citation
Ll. Judd, Course and chronicity of unipolar major depressive disorder: Commentary onJoiner, CL PSYCH-SC, 7(2), 2000, pp. 219-223
Citations number
20
Categorie Soggetti
Psycology
Journal title
CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE
ISSN journal
09695893 → ACNP
Volume
7
Issue
2
Year of publication
2000
Pages
219 - 223
Database
ISI
SICI code
0969-5893(200022)7:2<219:CACOUM>2.0.ZU;2-L
Abstract
Joiner (this issue) outlines an organizational framework of dysfunctional p sychological processes observed in unipolar major depressive disorder (MDD) patients, which he hypothesizes makes substantial contributions to the chr onicity of this common and disabling disorder. Rather than concentrating on the clinical characteristics, past history, biological markers, or genetic variables as risk factors for chronicity, Joiner references the scarring e ffects of repeated episodes and a set of destructive interpersonal processe s present in depressed patients that he feels promotes depressive chronicit y. This extends observations reported in prior studies on psychosocial disa bility in depression, which have concentrated primarily on such issues as e mployment status, estimates of well-being, and so on, whereas Joiner emphas izes psychological disability and disrupted interpersonal relationships. This commentary introduces a new dimension of chronicity of unipolar MDD th at involves the long-term, chronic manifestation of depressive symptomatolo gy, in addition to the frequent major depressive episode relapse. Further, the long-term symptomatic structure of unipolar MDD is described as a dimen sional continuum of symptom severity and illness activity and then highligh ted as to the relevance of both of these newer concepts to Joiner's proposa ls. A number of interesting research questions are outlined in by Joiner th at need empirical validation but, if answered, could make a contribution to the understanding and reduction of depression chronicity.