Dysfunctional attitude and childhood maltreatment predict future recurrence among young adults with first-onset depression: a prospective cohort study

Abstract

Background: The high prevalence of recurrent depressive episodes (RDE) among patients with major depressive disorder (MDD) has resulted in substantial personal, societal, and financial burdens. Although many studies have explored the factors associated with RDE, most have important methodological limitations. This study aims to examine the factors associated with RDE within two years among young adults with first-episode MDD. Method: A total of 324 patients aged 18 to 30 years with a first episode of MDD completed both the baseline assessment and the two-year follow-up. Personal, psychosocial, and illness-related variables were assessed at baseline. The status of RDE and medication use were evaluated at follow-up. Network analysis and logistic regression were performed to examine variables associated with RDE. Results: The two-year prevalence of RDE among patients with first-episode MDD was 42.28%. The network comparison test indicated no significant differences in network structure or global strength between the recurrence and non-recurrence groups. The edge difference test identified 19 significant differences between the two networks; however, none remained significant after FDR correction. Both network analysis and logistic regression showed that RDE was associated with medication use, followed by the ‘vulnerability’ subscale of dysfunctional attitudes and childhood emotional abuse. Conclusions: These findings suggest that dysfunctional attitudes, childhood emotional abuse, and medication use may have potential value in understanding the RDE.