Dr Shock MD PhD

Dr Shock became interested in optimism for a couple of reasons. He loves the blog findingoptimism written by someone with bipolar disorder and his partner. They both write excellent and compelling posts with very good tips and advice how to deal with mood disorder.

Recently there was a publication in Nature about brain area's responsible for optimism: the amygdala and the rostral anterior cingulate cortex. Both area's also come up on brain research with depressed patients. Wouldn't it be easy to hypothesize that low activity in these brain structures are responsible for depression and that optimism is expressed with activation of these centers. I know much to simple.

Nevertheless it made me wonder if there are any publications about the relation between optimism and depression.
1. Do optimistic people get depressed
2. Does optimism protect you from depression.
3. Can you diminish depression by focusing on optimism
4. Is optimism a trait or a state phenomenon?

I tried a search on PubMed with disappointing results. One publication came in the direction of my worrying.

In a large prospective cohort study of 464 men aged 64 to 84 years with a follow-up period of 15 years dispositional optimism was assessed at baseline and three consecutive assessments during the 15 years of follow up. At these three follow up assessments also the Zung self rating depression scale was administered. The objective was to answer the question whether dispositional optimism, defined as a personality trait with generalized positive outcome expectancies, life engagement, and a future orientation protects against the development of depression in community-dwelling elderly men.
For dispositional optimism a not validated earlier version of the same questionnaire was used as in the research in Nature on brain regions and optimism.

The cumulative incidence of depressive symptoms at 3 time points was 44% (Zung score higher than 50) and for more severe depressive symptoms it was 15% (Zung score higher than 60). Dispositional optimism protected against the development of depressive symptoms (depression was not assessed), during 15 years of follow-up in this group of elderly men.

The authors mention several other trials with comparable outcome although not with depression as such but mostly depressive symptoms or somatic illness.

Limitations
1. Depressive symptoms not depressive disorder
2. Correlation coefficients were of moderate strength
3. Relationship remained largely present with multivariate analyses which opposes the idea that there is simply a reciprocal relationship, more probably the relationship is more complex.
4. Optimism scale was not validated.
5. Depressive symptoms were only assessed at 3 of the 4 time points not at baseline


It would be interesting to incorporate dispositional optimism training in psychotherapy for depression. Found an example of optimism training on Vicarious Therapy

Related post on this blog:
8 tips how to become optimistic



Article discussed:
J Affect Disord. 2006 Mar;91(1):45-52. Epub 2006 Jan 27.
Dispositional optimism and the risk of depressive symptoms during 15 years of
follow-up: the Zutphen Elderly Study.
Giltay EJ, Zitman FG, Kromhout D.

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