Psychological Medicine

Original Articles

Dysfunctional attitudes and vulnerability to persistent depression

J. M. G. Williamsa1 c1, D. Healya1, J. D. Teasdalea1, W. Whitea1 and E. S. Paykela1

a1 MRC Applied Psychology Unit and Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge


Forty-four patients who met criteria for major depressive disorder were assessed for presence of dysfunctional attitudes and negative self-schema on admission. After six weeks, of sixteen patients who had shown high dysfunctional attitudes, six (35%) had not recovered. By contrast, of seventeen patients who had been equally severely depressed at the outset, but had low dysfunctional attitudes, only one (6%) had not recovered. The rating by the patients of themselves, as opposed to their attitudes, did not however predict. Thirty-one patients were tested six months later. Twenty-one (68%) remained asymptomatic, ten patients had relapsed or not responded to treatment, but neither type of admission measure predicted the state at this point. This is consistent with previous evidence which suggests that vulnerable attitudes assessed when symptomatic predict recovery, but that for prediction of relapse, cognitive measures need to be used when the patient is asymptomatic.


c1 Address for correspondence: Dr Mark Williams, MRC Applied Psychology Unit, 15 Chaucer Road, Cambridge, CB2 2EF.