Only one Thai study could be located that has
explored factors related to the recurrence of
depression.33 Also, no study could be located that has
investigated factors that affect relapses among persons
with a MDD. Even though the etiology of relapse is
unknown, Western research has focused on the clinical
factors that may predispose relapse among individuals
with a MDD.13, 15, 16, 18 Less attention has been given
to the psychosocial factors related to relapse (i.e.,
cognitive vulnerability, stressful life events, selfefficacy
for coping with depression, and expressed
emotion of family members) than to the clinical
characteristics related to relapse. Although a relapse
may originate from various factors, potential predictors
that may best explain a relapse remain unknown. Thus,
in order to provide a more comprehensive view of a
depressive relapse and gain insight into the factors that
contribute to an increased risk for a relapse, a need
exists for examination of the relationship among
psychosocial factors and relapse in persons with a
MDD.