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EV0812

Forgiveness, dignity, and hopelessness as therapeutic levers in major depression: A 2-year real-world follow-up study

FORGIVENESS, DIGNITY AND HOPELESSNESS AS THERAPEUTIC LEVERS IN MAJOR DEPRESSION: A 2-YEAR REAL-WORLD FOLLOW-UP STUDY

Antidepressant treatment combined with structured follow-up yielded sustained reductions in depressive symptoms, hopelessness, and dignity-related distress over 24 months, while forgiveness showed more limited changes over time.

This observational study conducted in real-world settings aimed to evaluate the longitudinal role of forgiveness, dignity, and hopelessness in patients with major depressive disorder (MDD) over a 2-year follow-up. The study enrolled 83 patients (47 women, 36 men; mean age 47.4 +/- 15.2 years) diagnosed with MDD according to DSM-5-TR criteria and admitted to psychiatric residential rehabilitation centers in southern Italy; inclusion criteria were HAM-D >= 14 and PHQ-9 > 5. All patients received antidepressant treatment (paroxetine, clomipramine, or venlafaxine) at fixed therapeutic doses in addition to the usual rehabilitation program and were assessed at baseline (T0), 6 months (T1), 12 months (T2), and 24 months (T3) using the Hamilton Depression Rating Scale (HAM-D), Patient Health Questionnaire (PHQ-9), Heartland Forgiveness Scale (HFS, total score), Beck Hopelessness Scale (BHS), and Patient Dignity Inventory (PDI); analyses used descriptive statistics and paired comparisons (paired t-tests). Depressive symptoms decreased progressively and significantly: HAM-D scores fell from 29.85 +/- 7.68 to 23.69 +/- 7.10, 19.51 +/- 6.77, and 15.64 +/- 5.61, respectively; PHQ-9 scores declined from 14.82 +/- 5.59 to 11.61 +/- 4.95, 7.77 +/- 5.03, and 7.64 +/- 4.07 (p < 0.001 for both). Hopelessness (BHS, from 8.96 +/- 3.83 to 4.64 +/- 3.66; p < 0.001) and dignity-related distress (PDI, from 60.16 +/- 20.16 to 52.75 +/- 15.60; p < 0.001) also improved significantly, while the reduction in total HFS scores was smaller (from 65.81 +/- 23.66 to 60.36 +/- 21.19; p = 0.037), and subscale analyses are ongoing. In conclusion, antidepressant treatment combined with structured follow-up in a rehabilitation setting was associated with clinically meaningful and sustained improvement over 24 months, whereas the trajectory of dispositional forgiveness appeared more complex.

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