Clinical use of coping in affective disorder, a critical review of the literature

BACKGROUND: The relationship between life stressors, coping and affective disorder is interesting when predicting onset of a affective disorder and relapse of mood episodes. METHODS: A litteratur review of cross-sectional and longitudinal studies concerning coping and affective disorder in adults including a Medline and Embase search was conducted. RESULTS: 11 cross-sectional studies and 17 longitudinal studies concerning affective disorder and coping were found, among these, two studies include patients with bipolar disorder exclusively. Only four studies elucidate whether emotion-oriented and/or avoidance coping styles are associated with a higher risk of developing affective disorder, so this hypothesis remains unclear. Most studies shows that emotion-oriented and avoidance coping strategies are associated with relapse of depressive episodes. Conversely, problem-focused and task-oriented coping seem to be associated with a good outcome. CONCLUSION: There is a gap between coping theory and clinical use of coping and the clinical relevance of coping is, though promising, still unclear. In future research it is recommended to concentrate on development of a semi-structured interview combining coping style, life events and personality traits.