ABSTRACT
OBJECTIVES: Previous research showed that positive and negative life events influence the development of depression. However, it is less clear how life events interact with depressive symptoms and self-esteem. DESIGN AND METHODS: The present study aimed to investigate the mediating effects of self-esteem on the relationship between life events and depressive symptoms in adulthood. The Traumatic Antecedent Questionnaire, Multidimensional Self-esteem Scale (MSWS), and Becks Depression Inventory were administered in 173 psychiatric inpatients (mean age 39.69 ± 14.56 years, ranging from 18 to 76 years). At the time of assessment, all patients suffered from depressive symptoms caused by an affective disorder (major depression, bipolar I, dysthymia). RESULTS: Path analyses showed that the individual level of self-esteem (measured by MSWS) fully mediated the association between positive life events and depressive symptoms. CONCLUSIONS: The current study indicates that future therapy programmes for patients with depressive symptoms could include interventions focusing on the improvement of self-esteem, as increasing self-esteem may be beneficial for recovery. PRACTITIONER POINTS: To date, this is the first study exploring the pathways from positive/negative life events to depressive symptoms. The relationship between positive life experiences and depressive symptoms was fully mediated by self-esteem. Strengthening self-esteem in therapy might lower the vulnerability for depression.
Subject(s)
Depression/psychology , Depression/therapy , Life Change Events , Mood Disorders/psychology , Self Concept , Adult , Female , Humans , Linear Models , Male , Middle Aged , Mood Disorders/therapy , Psychiatric Status Rating ScalesABSTRACT
OBJECTIVE: We aimed to investigate factors associated with self- and carer-rated quality of life (QoL) and caregiver burden related to very mild to severe clinical Alzheimer disease (AD). METHODS: One hundred patient-carer dyads were recruited, and assessments of relevant outcomes were performed, including sociodemographic characteristics, QoL, activities of daily living (ADL), cognitive performance, behavioural and psychological symptoms of dementia (BPSD), caregiver burden, and health resource utilisation. RESULTS: There was a strong correlation between carer- and self-rated QoL, with patients consistently rating their QoL higher than caregivers. Duration of illness did not affect the QoL ratings. There was an inverse association between both self- and carer-rated QoL with age, age at symptom onset, impairment of ADL, time spent on assisting the patient, and depression. Both self- and carer-rated QoL ratings were higher if the caregiver was a spouse vs a child. Carer-rated QoL was inversely associated with severity of dementia, BPSD, caregiver burden, and requirement to supervise the patient. The variables age at symptom onset, ADL, and living together with the primary caregiver explained 34.50% of the variance in self-rated QoL, whereas age at symptom onset, ADL, and BPSD explained 48.20% of the variance in carer-rated QoL. For caregiver burden, 26% of the variance was explained by the variables ADL, living together with the primary caregiver, and agitation. CONCLUSION: Our study highlights the need for a stronger focus on QoL in clinical AD research by providing further pieces of evidence on the key determinants, including the important aspect of caregiver burden.
