Objective

The aim of this exploratory study was to identify and follow persons with a first episode of major depression to determine whether sense of coherence changes over time. An additional purpose was to assess whether sense of coherence relates to depressive symptoms, aggression, and functional status either immediately following diagnosis or at four years post-diagnosis.

Methods

The study design was longitudinal; subjects participated in semi-structured interviews and completed surveys every 6 months starting at diagnosis and concluding 4 years later. The sample consisted of thirty-three adult patients who were being treated for first episode of major depression (DSM-IV). Sense of coherence was measured using Sense of Coherence Scale (SOC), depressive symptoms using the Montgomery Åsberg Depression Rating Scale, aggression, including a total score and subscales of anger and hostility, using the AQ Aggression Questionnaire — revised Swedish Version, and functional status using Global Assessment of Functioning scale and SF-36 Health Survey. The data were analyzed using Pearson's product moment correlation and repeated measures analysis of variance.

Results

At baseline, SOC was significantly correlated with total aggression (r = − 45) and the hostility subscale (r = − .73); baseline SOC was unrelated to depressive symptoms or functional status. SOC increased significantly over the time (p < .0001). At the four-year follow-up, SOC was significantly related to depressive symptoms (r = − .60), the aggression summary score (r = − .65), the anger subscale (r = − .52), the hostility subscale (r = − .77), the GAF (r = .64), and the physical and mental health components of the SF-36 (r = .74 and .72, respectively).

Conclusion

The finding that SOC increases as patients recover from MD suggests that treatment for depression may also bolster the patient's ability to cope, in addition to lowering depressive symptoms. The relationship between SOC and aggression in MD, with higher SOC correlated with lower aggression, needs to be examined further. © 2008 Published by Elsevier B.V.