Postprint version. Published in Journal of Psychosomatic Research, Volume 53, Issue 4, October 1, 2002, pages 877-881. Publisher website: http://www.elsevier.com. The definitive version is available online at: http://dx.doi.org/10.1016/S0022-3999(02)00315-X
NOTE: At the time of publication, the author Suzanne Phelan was not yet affiliated with Cal Poly.
Depression has been linked to poor health outcome in a number of studies; however, the mechanism underlying this relationship has received little attention. This paper explores the possibility that adherence mediates the relationship between depression and outcome. Principal findings regarding the relationship between depression, adherence, and outcome are reviewed. The data suggest that depression is related, at least moderately, to poorer adherence to a variety of treatment components. The relationship between adherence and outcome is more difficult to establish. In addition, current data, albeit limited, do not support the hypothesis that adherence mediates the relationship between depression and outcome. An alternative model in which adherence precedes and influences both mood state and health outcome is discussed. Finally, possible explanations for these relationships are explored and suggestions for future research provided.