The influence of an uncaring partner on the type and outcome of depression

Background: We seek to clarify recent inconsistent research findings in rel ation to the Intimate Bond Measure (IBM), where low IBM care scores have be en held to be over-re presented in non-melancholic depression and to predic t a poor depressive episode outcome. Methods: A sample of 82 subjects meeti ng DSM criteria for a major depressive episode lasting less than 2 years, t ook part in a 1-year follow-up study. The IBM was completed at initial asse ssment and depression severity assessed at baseline and at follow-up assess ment. allowing a measure of 'outcome'. Results: A significantly greater pro portion of DSM-defined non-melancholic than melancholic depressives perceiv ed their partner as providing deficient care and were classified as being i n a dysfunctional relationship, seemingly unrelated to demographic differen ces or by depression severity, chronicity or recurrence. IBM scores were ag ain established as independent of a number of putative distorting influence s, such as depression severity and 'neuroticism'. Although the IBM failed t o significantly predict outcome, there was a clear trend for greater improv ement in those in IBM care score-defined 'functional relationships'. Limita tions: The study failed to assess the change in patients' perceptions of ca re over time, which may have contributed to the failure to replicate past f indings in relation to outcome, Conclusions: The significance of examining the relevance of psychosocial factors such as deficient intimacy to separat e depressive sub-types is highlighted. Implications of these findings for c linical intervention and future research studies are discussed. (C) 2001 El sevier Science B.V. All rights reserved.