Over-reporting of maladjustment by depressed subjects

The extent to which patients' reports of maladjustment is influenced by depressive symptoms was estimated in 25 acute depressed patients responding to pharmacotherapy. Their social adjustment over the same four-month period immediately prior to hospitalization was assessed on two separate occasions: firstly when they were acutely depressed, and again a mean of 20 days later when clinically recovered. Significant differences between the two reports were found in mean score of maladjustment in four out of five fields of social adjustment (work, social/leisure life, family of origin, marriage, and sex). The reduction in depressive symptoms scores (of pessimism considered separately), correlated significantly with changes in the total maladjustment score. The reduction in pessimism scores correlated with changes in the scores for both work and social/leisure fields, and also accounted for 40% of the total variance in maladjustment score. These results indicate that impaired social adjustment as assessed during the height of the depressive illness arises in part from a symptom-related overreporting bias leading patients to make a harsh appraisal of themselves.