Abnormal Time Experiences in Major Depression: An Empirical Qualitative Study

In major depressive disorder, abnormal time experience is nearly universal: 96 out of 100 patients reported at least one disturbance. The most common patterns are a sense of stagnation in vital processes, feeling trapped by the past so that the present and future seem dominated by it, and a slowing of the flow of time. Unlike in schizophrenia, where time experience becomes fragmented, depression involves a blockage or inhibition of forward movement. These findings confirm that distorted time perception is a core feature of depression, which could aid differential diagnosis and distinguish true depression from milder forms.

Study at a glance

Abstract

BACKGROUND: Phenomenological psychopathology, through theoretical and idiographic studies, conceptualizes major depressive disorder (MDD) as a disorder of time experience. Investigations on abnormal time experience (ATE) in MDD adopting methodologies requested by the standards of empirical sciences are still lacking. Our study aimed to provide a qualitative analysis, on an empirical ground and on a large scale, of narratives of temporal experiences of persons affected by MDD. METHODS: We interviewed 550 consecutive patients affected by affective and schizophrenic disorders. Clinical files were analysed by means of consensual qualitative research. RESULTS: Out of 100 MDD patients, 96 reported at least 1 ATE. The principal categories of ATE are vital retardation - the experience of a stagnation of endogenous vital processes (37 patients), the experience of present and future dominated by the past (29 patients), and the experience of the slackening of the flow oftime (25 patients). A comparison with ATE in schizophrenia patients showed that in MDD, unlike in schizophrenia, there is no disarticulation of time experience (disorder of temporal synthesis) but rather a disorder of conation or inhibition of becoming. LIMITATIONS: The interview style was not meant to make a quantitative assessment ("false negatives" cannot be excluded). CONCLUSIONS: Our findings confirm the relevance of distinctive features of ATE in MDD, support the hypothesis of an intrinsic disordered temporal structure in depressive symptoms, and may have direct implications in clinical practice, especially in relation to differential diagnosis, setting the boundaries between "true" and milder forms of depression, and neurobiological research.