Emotional dysregulation, specifically affective instability, is related to and an indicator for major depressive disorder, according to a recent publication in the Journal of Affective Disorders.

Researchers recruited 1592 participants between the ages of 55 and 64 years old for baseline measurements and then follow-up measurements every 6 months for 5 years, to reach a total of 10 time points. The participants were evaluated for baseline demographics, reported affective instability, depressive symptoms, and major depressive disorder diagnosis.

At baseline, 25.4% had experienced a major depressive event; at the 5th time point, 12.2% had experienced a major depressive event; and at the 10th time point, 10.4% had experienced a major depressive event. Participants who had a major depressive episode at baseline had higher affective instability when compared with participants who never had major depressive disorder (P <.001) or those in remission (P <.01). Affective instability at baseline increased risk for a first-time major depressive episode and depressive symptoms.

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Remission occurred in 90.7% of participants who had experienced a major depressive episode at some time point, but remission rates were not associated with affective instability. Findings did reveal that women’s self-reported affective instability predicted depressive symptoms over time. Future studies must examine the specific mechanisms that relate affective instability and major depressive disorder and whether changes in affective instability are related to changes in major depressive disorder.

In conclusion, affective instability is associated with major depressive episodes and a diagnosis of major depressive disorder, but it is not associated with an increase in depressive symptoms over time or remission rates.

This study was supported by the National Institutes of Health.


Eldesouky L, Thompson RJ, Oltmanns TF, English T. Affective instability predicts the course of depression in late middle-age and older adulthood.  J Affect Disord. 2018;239:72-78. doi:10.1016/j.jad.2018.06.038