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Negative self-schemas and the onset of depression in women: longitudinal study.

Evans J, Heron J, Lewis G, Araya R, Wolke D,

Division of Psychiatry, University of Bristol, Cotham House, Cotham Hill, Bristol BS6 6JL, UK. j.evans@bristol.ac.uk

BACKGROUND: Beck's cognitive theory of depression has received little empirical support. AIMS: To test whether those with negative self-schemas were at risk of onset of depression. METHOD: Data were collected by postal questionnaire from 12,003 women recruited during early pregnancy; questionnaires included measures of depressive symptoms and negative self-schemas. Regular questionnaires were sent during pregnancy and following childbirth. RESULTS: Of 8540 women not depressed when recruited, 8.6% (95% CI 8.0-9.2) became depressed 14 weeks later. Those in the highest tertile for negative self-schema score were more likely to become depressed than those in the lowest tertile (odds ratio 3.04, 95% CI 2.48-3.73). The association remained after adjustment for baseline depressive symptoms and previous depression (OR 1.6, 95% CI 1.27-2.02) and was of similar magnitude for onset 3 years later. CONCLUSIONS: Holding a negative self-schema is an independent risk factor for the onset of depression in women. This finding supports a key element of Beck's cognitive theory. Understanding more about how negative self-schemas arise should help inform preventive policies.

Published 1 April 2005 in Br J Psychiatry, 186: 302-7.
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