The role of psychological variables in recurrent depressive disorder and their association with episode severity: A cross-sectional study

Background: Recurrent depressive disorder (RDD) is characterized by repeated depressive episodes with significant functional impairment and relapse risk. Psychological variables such as perceived stress, stressful life events, and personality traits are increasingly recognized as important determinants influencing the onset, recurrence, and severity of depressive episodes. Aim: To assess the role of psychological variables in RDD and their association with the severity of depressive episodes. Materials and Methods: A hospital-based, cross-sectional study was conducted among 80 patients diagnosed with RDD. Sociodemographic and clinical data were collected using a semi-structured pro forma. Psychological variables were assessed using the Perceived Stress Scale, Holmes-Rahe Life Stress Inventory, and NEO Five-Factor Inventory, while depressive severity was evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS). Statistical analysis was performed using descriptive statistics, Chi-square test, ANOVA, and correlation analysis with significance set at P < 0.05. Results: The majority of the participants experienced moderate perceived stress, which was significantly associated with moderate depressive severity. High perceived stress and greater life event burden were associated with increased MADRS scores and a higher proportion of severe depressive episodes. Maladaptive personality traits, including gloomy pessimism, maladaptive defense patterns, temperamental anger, and poor impulse control, were significantly associated with greater depressive severity. Psychological variables collectively demonstrated a significant association with depressive episode severity. Conclusion: Psychological variables play a crucial role in determining depressive episode severity in RDD. Assessment and management of stress perception, life events, and maladaptive personality traits are essential for improving treatment outcomes and reducing recurrence risk.