Resilience and depressive symptoms in inpatients with depression: A cross-lagged panel model

Background: Resilience-the ability to bounce back or quickly recover from stress-has been found to predict treatment outcome in patients with mental disorders such as depression. The current study aimed to test whether resilience itself changes during treatment and whether resilience exclusively predicts changes in depressive symptoms or whether depressive symptoms also predict changes in resilience. Methods: Inpatients with depression (N=2165; average length of stay M=60 days, SD=32) completed the Brief Resilience Scale and the Patient Health Questionnaire Depression Scale at admission and discharge, scores of which were used to run a cross-lagged panel model. Results: Resilience increased and depressive symptoms decreased from admission to discharge. Cross-sectionally, higher resilience was related to lower depressive symptoms at admission and at discharge. Prospectively, higher resilience at admission predicted stronger decreases in depressive symptoms, and higher depressive symptoms at admission predicted smaller increases in resilience. Limitations: Self-report questionnaires may potentially be biased (e.g., through recall bias, social desirability, or demand effects). Conclusions: The current study further supports that resilience is related not only to fewer mental health problems cross-sectionally but also is sensitive to change and a predictor of treatment outcome in patients with mental disorders. Given this pivotal role in mental health, the current findings highlight the importance of prevention and intervention approaches for promoting resilience in the general population and in persons with mental disorders in particular.