The association of perseverative negative thinking with depression, anxiety and emotional distress in people with long term conditions: A systematic review
Introduction
Chronic physical illnesses (i.e. long term conditions – LTCs) are conditions that cannot currently be cured but can be managed with treatment e.g. asthma, diabetes, coronary heart disease. It is estimated that 15 million people in England have a LTC, and people with LTCs account for 70% of all health and care spending [1].
Depression is common in people with chronic physical illnesses [2], [3] and is associated with worse medical outcomes such as increased morbidity and mortality [4], [5], [6], [7], worse health-related quality of life [8], [9], [10], and increased healthcare utilisation [11], [12]. Understanding the factors contributing to the development of depression among people with LTCs could therefore: i) help identify who is at increased risk of developing depression and worse medical outcomes, ii) facilitate the stratification and personalisation of psychological and/or medical management and iii) lead to the development of novel interventions that might improve both depression and other health outcomes. Biological, psychological and social risk factors for depression have been identified among people with long term conditions [13], [14], [15], [16], [17], though findings from previous research are often mixed and contradictory. Furthermore, many of the risk factors identified are inter-related and the most important factors predicting (and potentially causing) depression in people with LTCs remain unclear [18].
Perseverative negative thinking is a term used to describe processes such as worry and rumination, in which individuals experience repetitive, prolonged and recurrent negative thoughts about themselves, their symptoms, their problems, or their concerns [19]. Perseverative negative thinking predicts negative affect [20], [21], [22], [23], [24], [25], including the onset, maintenance and relapse of depression (e.g. [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40]). Such thinking also predicts adverse medical outcomes, such as poor cardiovascular health, impaired wound healing and immune dysfunction [41], [42], [43]. These findings suggest that perseverative negative thinking could be a potential target for interventions aimed at improving both medical and psychological outcomes. Most previous prospective research into perseverative negative thinking has focused on physically healthy populations, however. The characteristics of perseverative negative thinking and the nature of its associations with psychological outcomes among people with LTCs are not clear.
The aims of this systematic review are to clarify the temporal relationship and the strength of association between perseverative negative thinking and depression, anxiety and emotional distress among people with LTCs.
Section snippets
Method
This review was conducted following the guidance of the University of York Centre for Reviews and Dissemination [44] and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement [45]. The review protocol was previously published [46].
Study selection
Details of study selection are shown in Fig. 1. Thirty eligible studies were included in the review [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77], [78], [79], [80], [81], [82]. Authors of a further 46 potentially eligible studies were contacted for additional data; authors of 15 studies were unable to provide additional data, and authors of 31 did not respond. It was not possible
Discussion
We conducted a systematic review to clarify among people with LTCs the temporal relationship between perseverative negative thinking, on the one hand, and depression, anxiety or emotional distress, on the other, and to determine the strength of the prospective associations. Findings were limited mainly to the association of rumination and/or catastrophizing with subsequent depression. The majority of uncontrolled studies showed an association between measures of perseverative negative thinking
Acknowledgements
The authors declare that they have no competing interests. This research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. This research was also supported by a University of Exeter Medical School PhD Studentship awarded
References (84)
Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability
Gen. Hosp. Psychiatry
(2007)Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research
Gen. Hosp. Psychiatry
(2011)Depression, chronic diseases, and decrements in health: Results from the world health surveys
Lancet
(2007)Does depression predict the use of urgent and unscheduled care by people with long term conditions? A systematic review with meta-analysis
J. Psychosom. Res.
(2012)Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome
Gen. Hosp. Psychiatry
(2011)Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms
J. Psychosom. Res.
(2002)- et al.
Emotion-regulation strategies across psychopathology: a meta-analytic review
Clin. Psychol. Rev.
(2010) - et al.
The effects of worry and rumination on affect states and cognitive activity
Behav. Ther.
(2007) Preliminary exploration of worry: some characteristics and processes
Behav. Res. Ther.
(1983)Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults
J. Adolesc.
(2002)
Cognitions, coping and social environment predict adjustment to phantom limb pain
Pain
Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy
Pain
The course of depression in recent onset rheumatoid arthritis: the predictive role of disability, illness perceptions, pain and coping
J. Psychosom. Res.
Pain-related catastrophizing: a daily process study
Pain
A prospective evaluation of the chronic pain self-management Programme in a Danish population of chronic pain patients
Patient Educ. Couns.
One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: a latent class growth analysis
J. Psychosom. Res.
Long Term Conditions Compendium of Information
Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence
Med. J. Aust.
Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis
Psychosom. Med.
Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis
Psychosom. Med.
Medical co-morbidity in depressive disorders
Ann. Clin. Psychiatry
Depression and health-related quality of life in people with coronary heart disease: a systematic review
Eur. J. Cardiovasc. Nurs.
Diabetes, depression, and quality of life a population study
Diabetes Care
Depression in adults with long term conditions 1: how to identify and assess symptoms
Nurs. Times
The risk factors for depression in first myocardial infarction patients
Psychol. Med.
Depression in rheumatoid arthritis: a systematic review of the literature with meta-analysis
Psychosom. Med.
Predictors of depression in a sample of 1021 primary care patients with osteoarthritis
Arthritis Care Res.
Predictors of psychiatric morbidity in cancer patients
Br. J. Psychiatry
A multidimensional structure for repetitive thought: what's on your mind, and how, and how much?
J. Pers. Soc. Psychol.
Constructive and unconstructive repetitive thought
Psychol. Bull.
Rethinking rumination
Perspect. Psychol. Sci.
The association between rumination and negative affect: a review
Cognit. Emot.
Self-focused attention and negative affect: a meta-analysis
Psychol. Bull.
Rumination and distraction: selected findings related to the response styles theory
Psychother. Psychosom. Med. Psychol.
Effects of responses to depression on the remediation of depressive affect
J. Pers. Soc. Psychol.
A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake
J. Pers. Soc. Psychol.
Effects of rumination and distraction on naturally occurring depressed mood
Cognit. Emot.
Response styles and the duration of episodes of depressed mood
J. Abnorm. Psychol.
The response styles theory of depression: tests and an extension of the theory
J. Abnorm. Psychol.
The role of rumination in depressive disorders and mixed anxiety/depressive symptoms
J. Abnorm. Psychol.
Rumination as a common mechanism relating depressive risk factors to depression
Emotion
Worry and rumination: repetitive thought as a concomitant and predictor of negative mood
Cogn. Ther. Res.
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