First based upon cognitive theory persons with a MDD who relapse are more likely to perceive themselves and their world in a more negative manner than those with a MDD who are not in relapse. Thus regardless of the factors that may be related to relapse a person with a MDD who is in relapse will be more likely to maintain symptoms of depression than a person who has a MDD but is not in relapse. This factor will continue to be a problem in future reasearch studies.