Many studies have shown that patients value their somatic condition more favorably than healthy individuals. The opposite has been found for depression, as people with depression seem to value depression worse than non-depressed people. However, studies on this topic are limited in number and methodologically limited. Several factors such as low adaptive skills or stigma have been hypothesized to account for observed discrepancies, but have not been examined before.
We studied:
a. whether individuals with and without depression differ in their valuations of depression.
b. and if so, whether these discrepancies are explained by demographic characteristics, cognitions (i.e. stigma towards, perceptions of, perceived susceptibility to depression, dysfunctional attitudes) and personal resources (i.e. mastery, empathy, self-compassion).
Method:
Thirty states of depression were constructed based on the McSad classification system and rated by experts concerning their severity. Participants performed an online-administered Time-Trade-Off task to value four randomly selected states, and completed additional questionnaires. The PHQ-9 cut-off score was used to distinguish people with and without depression. A generalized linear mixed model was used to examine the effect of depression group, as well as of the demographic-, cognitions- and personal resources-related variables on depression valuations.
Result:
The sample (N=1268) was representative of the Dutch population regarding age (Mean:46,6; SD:17,4), gender (women:648), education and residence. We found a significant interaction effect between depression group and states on valuations of depression (p<0.001), meaning that significant differences between people with (N=200) and without depression (N=1068) were observed, but not among all 30 states. Differences were significant for the majority of milder states, but less consistent among the moderate/severe states. As hypothesized, all significant differences indicated lower valuations of people with depression. The group difference remained even after taking socio-demographic-, cognition- and personal resources-related variables into account, indicating an independent effect of depression group on valuations.
Conclusion:
This large-scale study showed that compared to non-depressed, people with depression value depression worse, although differences are more consistent among the milder states rather than the moderate/severe states.
Furthermore, our findings imply a genuine effect of experience with depression on valuations even when demographic characteristics, cognitions and personal resources are taken into account.