Stressful events, stress perception and treatment outcomes in patients with depressive disorders: The CRESCEND study

Jae Min Kim, Sung Wan Kim, Robert Stewart, Hee Ju Kang, Il Seon Shin, Sung Won Jung, Min-Soo Lee, Hyeon Woo Yim, Tae Youn Jun

    Research output: Contribution to journalArticlepeer-review

    15 Citations (Scopus)


    Background: Investigations of associations between stressful events and depression treatment outcomes have led to conflicting findings. In a prospective naturalistic study of depression treatment we sought to investigate perceived stress as a predictor of 12-week antidepressant treatment outcome. Methods: A nationwide sample of 580 people with depressive disorders was recruited from 18 hospitals in Korea. Number of stressful events in the last 12 months and subjective perception of stress were ascertained, and were dichotomized by median values. Participants commenced on antidepressant treatment were re-evaluated at 1, 2, 4, 8, and 12 weeks later. Assessment scales for evaluating depression (HAMD), anxiety (HAMA), global severity (CGI-s), and functioning (SOFAS) were administered at baseline and at every follow-up visit. Covariates included pre-treatment socio-demographic and clinical characteristics, and treatment-related characteristics. Results: Higher baseline perceived stress was significantly associated with worse 12-week antidepressant treatment outcomes in terms of depression, anxiety, and global severity after adjustment for all covariates. However, baseline number of stressful events was not associated with any treatment outcomes. Limitations: The study was observational, and the treatment modality was naturalistic. Conclusions: Depressive patients with higher level of perceived stress at the time of commencing treatment had less favorable outcomes after antidepressant treatment. This may represent a group requiring more specific assessment and more intensive management in order to improve treatment response.

    Original languageEnglish
    Pages (from-to)528-536
    Number of pages9
    JournalJournal of Affective Disorders
    Issue number3
    Publication statusPublished - 2011 Oct 1


    • Antidepressant
    • Depression
    • Korea
    • Stress
    • Treatment outcome

    ASJC Scopus subject areas

    • Clinical Psychology
    • Psychiatry and Mental health


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