July 11, 2006

Mild Sadness May Trigger Depression Anew

NEW YORK (Reuters Health) - For people who have recovered
from a bout of clinical depression, mild emotional stress or
sadness can reactivate depressive thinking and this may
increase the risk of relapse, researchers report.

Remission from depression can be "a period of marked
sensitivity to emotional stress as well as an increased risk of
relapse," Dr. Zindel V. Segal, of the University of Toronto,
Ontario, Canada, and colleagues write in the Archives of
General Psychiatry.

The researchers examined if mood-linked changes in thinking
predicted relapse in 301 adults recovering from a major
depressive disorder.

In the first phase of the study, the patients were treated
with antidepressant medication or cognitive behavior therapy.
In phase 2, regular clinical assessments were conducted for 18
months in the 99 patients who achieved clinical remission.

During the second phase, the subjects underwent sad mood
provocation. They were asked to recall a time in their lives
when they felt sad, and at the same time the researchers had
them listen to the orchestral introduction to "Russia Under the
Mongolian Yoke" by Prokofiev, played at slow speed. Previous
studies have found this to bring on an unhappy mood.

Compared with patients who underwent cognitive behavior
therapy, those who received antidepressant medication showed a
greater tendency to have depressive thoughts after mood
provocation. The magnitude of the mood-linked response
predicted relapse during the 18 months, regardless of the type
of previous treatment.

These findings suggest that "even a mild negative mood,
when experienced by someone with a history of depression, can
re-instate some of the cognitive features observed in
depression itself," Segal's team concludes.

SOURCE: Archives of General Psychiatry, July 2006.