Antidepressant treatment is associated with changes in early maladaptive schemas in major depressive disorder: a prospective study

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Introduction Early maladaptive schemas (EMS) have been increasingly recognized as key cognitive vulnerability factors in depression. This study aimed to evaluate the effects of antidepressant treatment on early maladaptive schemas (EMS) and to examine the relationships between EMS and demographic and clinical factors in major depression. Methods We conducted a three-month prospective study including 80 patients diagnosed with a major depressive disorder. EMS were assessed using the Young Schema Questionnaire Short Form (YSQ-S2), and depression severity was measured using the Hamilton Depression Rating Scale at baseline (T0) and after 3 months of antidepressant treatment (T3). Results After 3 months of antidepressant treatment, mean EMS scores significantly decreased, except for the Entitlement schema. No significant correlations were found between EMS scores and depression severity at baseline or follow-up. Additionally, baseline depression severity did not predict changes in EMS scores, except for the defectiveness/shame schema. Conclusion Antidepressant treatment was associated with a significant reduction in most EMS. These findings underscore the importance of additional research on cognitive plasticity of EMS and the mechanisms underlying treatment effects, which could inform more personalized and effective therapeutic strategies.