The influence of interpersonal factors on the speed of recovery from major depression

Abstract

Abstract Previous research has established that a subsample of depressed patients may experience an early positive response to psychotherapy. The preconditions of this phenomenon were studied in 62 depressed adults receiving 16 weekly sessions of supportive–expressive dynamic psychotherapy. One third of the sample experienced an early rapid response (ERR), defined as a reduction of at least 50% of their intake Beck Depression Inventory score by Week 6. Despite equivalent ratings of working alliance between ERR and non-ERR patients, the former were five times more likely to recover. Pretherapy characteristics of depressed patients less likely to rapidly respond included a lower interpersonal mastery, a more domineering interpersonal style, and greater social isolation and attachment fears concerning intimacy. As a whole, these findings suggest that ERR and non-ERR patients present with dissimilar interpersonal patterns, requiring different psychotherapeutic approaches.