Thinking, depression, and antidepressants: Modified and unmodified depressive beliefs during treatment with amitriptyline

Abstract

Sixty depressed inpatients were treated exclusively with antidepressant medication and released at the resolution of their major depressive episodes. These individuals were studied over a 4-year period using a questionnaire that examined personal attitudes toward a variety of beliefs: a shortened form of the Dysfunctional Attitude Scale (DAS). The DAS was administered to the patients upon their admission to the hospital (test), upon their release (retest), and again 1 year after their discharge (follow-up)—the latter obtained with 30 of the original sample. The psychiatrists filled out Hamilton's Rating Scale for Depression (HRS-D) on the same occasions. In this way, it was possible to examine the correlation between changes in depressive symptomatology and cognitive processes—specifically, the extent and nature of changed and unchanged client beliefs during the pharmacological intervention. The depressed group was compared with a homogeneous control group that filled out the DAS at the same times. Although many of the 37 beliefs examined had undergone significant change by the end of each client's depressive episode, 5 beliefs appeared to be quite resistant to change, persisting even 1 year after discharge. These specific beliefs may be differentially important in the cognitive organization of people prone to major depressive episodes.