A study published in the current issue of Psychotherapy and Psychosomatics has examined psychological well-being in patients who have recovered from depression.

Psychological well-being (PWB) might play a central role in the maintenance of mental health. PWB is based on the eudaimonic concept of well-being and encompasses six dimensions: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. There is some evidence that a lack of PWB increases the vulnerability to future depressive episodes, even after controlling for several risk factors such as prior depression, personality, economic status, and physical health.However, to demonstrate the specific role of PWB in the course of depression, remitted individuals have to be compared not only to controls, but also to currently symptomatic individuals.

Therefore, the primary goal of our study was to assess PWB in remitted depressed patients, healthy controls, and acutely depressed patients. Three groups of participants (total sample n = 156) were recruited. Data of remitted patients with recurrent depression (RD; n = 63) were collected within a larger trial comparing cognitive-behavioral maintenance therapy and psychoeducation .  Acutely depressed patients (AD; n = 43) were recruited in the outpatient clinic at the Department of Psychology, University of Jena, Germany. Most patients received psychopharmacological treatment. The healthy control group (n = 50) was recruited via newspaper advertisement. Inclusion criteria were the absence of current mental disorders and history of major depression. Participants of all three groups had an age of 18-70 years.

All patients completed the scales of PWB. The three groups did not differ significantly in gender, but they did in age. RD patients were significantly older than AD patients and controls. The three groups differed significantly on all PWB scales .Both RD and AD patients had significantly lower scores on each PWB scale than controls . RD and AD patients did not differ significantly in scores of PWB scales, except for the self-acceptance scale, on which AD patients showed a significantly lower score than RD patients.

The current study showed that even when recurrent depressed patients have been remitted for at least 2 months, impairments of PWB such as self-acceptance or relationships to others persist. Moreover, PWB of RD patients did not differ from PWB of AD patients. This suggests that a low level of PWB might represent a possible risk factor for depressive recurrences . The results suggest that besides focusing on psychopathological symptoms, a broader view incorporating humanistic and existential concepts of mental health may be a promising approach to RD .  Well-being therapy is effective in the prevention of depressive recurrences not only in the short term, but also up to a 6-year follow-up. Since well-being therapy is not a symptom-oriented treatment, but aims at enhancing resilience under stress on a more general level , it may not only be effective in reducing vulnerability to mood disorders, but to mental disorders in general.

This article first appeared on News Medical on 5 December, 2013.