Antidepressant treatment modulates early maladaptive schemas in depressive disorder

Background: Early maladaptive schemas (EMS) are considered a vulnerability marker in a wide range of psychological disorders, particularly depressive disorders. This study aims to to evaluate the effects of antidepressant treatment on these cognitive schemas and to study the relationships between EMS and demographic and clinical factors in major depression. Methods: We conducted a three-month prospective study of 80 patients with a major depressive disorder according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V); who were treated with antidepressant medication. EMSs were assessed using the Arabic version of the Young Schema Questionnaire Short Form, and depression severity was measured using the Hamilton Depression Rating Scale before and after 3 months of antidepressant treatment. Results: The EMSs with the highest scores in depressed subjects were: self-sacrifice, social isolation, emtional deprivation, and abandonment/instability schemas. After 3 months of antidepressant treatment, mean EMSs scores decreased significantly, with the exception of the Entitlement schema. A linear regression showed that baseline depression severity (Hamilton T0) did not predict changes in EMSs scores, except for the failure s chema. Scores for all EMSs were not correlated with the initial severity of the depressive disorder or its severity after 3 months of treatment. Conclusion: Mean scores for most EMSs decreased significantly after 3 months of antidepressant treatment. These results underscore the importance of additional research on cognitive plasticity of EMSs and the mechanisms underlying treatment effects, which could inform more personalized and effective therapeutic strategies.