3 - (OP5) Fear of Depression Recurrence and Its Impacts on Daily Mood, Depressive Symptoms, Social Functioning, and Health Behaviors Among Remitted Depressed Individuals

Background: Major depressive disorder (MDD) is a prevalent, burdensome, and often recurrent mental health condition. Little is known about the unique cognitive processes that occur during remission from MDD that may increase one’s risk of recurrence. Fear of illness recurrence may be relevant to MDD recurrence risk through associated behavioral and affective changes.

Aims: We examined how fear of depression recurrence (FoDR) might influence daily mood, social functioning, sleep, eating patterns, and physical activity, as well as depressive symptoms across time among individuals with remitted MDD. Further, we also explored whether mood, health behaviors, and social functioning mediated the association between FoDR and depressive symptoms.

Methods: Ninety-nine adults in remission from MDD completed a questionnaire battery and a five-day period of mobile ecological momentary assessment (EMA) at three time points, each one month apart. Latent growth curve modeling was used to measure cross-sectional, prospective, and parallel associations between variables.

Results: Elevated levels of FoDR predicted prospectively (B = 1.13, SE = 0.35, p = .001), and in parallel (B = 3.47, SE = 1.07, p = .001), higher depressive symptoms across time. Increasing FoDR over time was associated with increasing negative mood (B = 0.13, SE = 0.06, p = .019) and decreasing positive mood (B = -0.29, SE = 0.07, p < .001) in parallel. No mediating effects or associations between FoDR and social functioning variables were observed. FoDR at time 1 was associated with higher uncontrolled eating scores at time 1 (B = 0.87, SE = 0.31, p = .005) and less engagement in moderate physical activity over time (B = -0.09, SE = 0.04, p = .016), while increasing FoDR over time was associated with decreasing quality of sleep in parallel (B = -0.51, SE = 0.25, p = .041). In addition, reduced sleep quality at time 2 mediated the positive associations between FoDR at time 1 and depressive symptoms at time 3 (indirect = .325, 95% CI [0.019, 0.969]).

Conclusion: FoDR may be a unique risk factor for worsening mood and depressive symptoms in persons with remitted MDD, and it appears to negatively influence multiple health behaviors, particularly sleep quality. Addressing FoDR may therefore be a promising avenue for promoting wellbeing following a major depressive episode and possibly reducing risk of recurrence.