Relationship of Number of Depression Episodes with Depression Severity, Treatment Adherence, Stress, Personality, Executive Functions and Decision-Making

Abstract

Major depressive disorder (MDD) is a psychiatric disorder that significantly affects the world population. The aim of this study was to investigate the relationship between the number of episodes and severity of depression, treatment adherence, perceived stress, personality, executive functions and decision making in MDD patients. Measurement tools including Beck Depression Inventory (BDI), Morisky Medication Adherence Scale (MMAS), Perceived Stress Scale (ASO-14), Temperament and Personality Inventory-Revised Form (TCI-R), Wechsler Memory Scale-III/Letter-Number Sequence Subtest (HSD), Wisconsin Card Sorting Test (WCST), Stroop Test TBAG Form (STR) and Iowa Gambling Taskt (IGT) were used in the study. The findings of the study showed that the severity of depression in MDD was not related to the number of episodes (r=-0.051, p>0.05) and treatment compliance (r=-0.082, p>0.05), but there was a significant relationship between the number of episodes and treatment compliance (r=-0.880, p<0.001). As the number of episodes increased, the perceived stress level and the level of knowledge about treatment decreased, whereas reward addiction and novelty seeking among personality traits increased. Executive functions and decision-making functions were also found to be weaker in MDD patients with recurrent episodes. The severity of depression in MDD was not associated with the number of episodes and medication adherence, suggesting that other variables associated with recurrent episodes should be addressed. In cases of recurrent MDD, in addition to factors such as medication adherence, perceived stress and personality, executive functions and decision-making behavior are also influential and should be closely monitored. Thus, it seems necessary to evaluate cognitive intervention options in the follow-up and treatment process of MDD.