gms | German Medical Science

Background: Early Maladaptive Schemas (EMS) are a result of early developmental experiences of unmet basic emotional needs, and play a causal role in the development of later psychopathology, including depression severity and episodes of major depression [1], [2].

Aim: The aim of the study was to investigate the influence of EMS on depression severity and treatment outcome in an ambulant psychiatric rehabilitation setting.

Method: The German short version of the Young Schema Questionnaire (YSQ-S3) was applied to assess EMS, and depressive symptoms were assessed using the Beck Depression Inventory II. A total of 650 patients were included, and statistical analyses were performed using SPSS 24.0 and AMOS.

Results/findings: The prediction of BDI-II scores by means of the 18 schemas of the YSQ showed explained variance of 50%, and different schemas showed varying influence on BDI-II results. Significant predictive values were found for the schemas defectiveness/shame (r=.197), dependence/incompetence (r=.298), self-sacrifice (r=.097) and negativity (r=.169).

Dividing our sample in clusters according to their change in BDI-II from admission to discharge (significant improvement: improvement by 8 points, no significant change, significant deterioration: deterioration by 8 points), the latter cluster showed significantly higher schemas scores in all schema domains.

Discussion and conclusions: Specific EMS were related to depressive symptom severity and could explain 50% of variance, supporting previous findings [2]. However the specific schemas seem to vary across different samples.

Besides, lower schema scores were associated with better treatment response to psychiatric rehabilitation.

In conclusion, specific maladaptive schemas are related to depressive symptom severity, and patients with high schema scores might benefit from a schema-focused treatment programme.