# Associations between self-management strategies and clinical outcomes in depression: a cross-sectional survey

## TL;DR

This study found that using more self-management strategies is linked to better recovery in people with depression, more so than symptom reduction.

## Contribution

The study identifies specific self-management strategies and their associations with recovery in depression.

## Key findings

- The number of useful self-management strategies was weakly negatively correlated with depressive symptom severity.
- The number of useful strategies was moderately positively correlated with personal recovery.
- Participants used an average of 20.8 strategies, with 13.1 rated as useful.

## Abstract

Self-management is essential for coping with depressive symptoms, yet little is known about its associations with depressive symptoms and personal recovery.

We conducted a cross-sectional questionnaire survey of 183 outpatients with major depressive disorder in Japan between October 2024 and June 2025. Participants reported the use and perceived usefulness of 63 self-management strategies. Associations between the number of strategies and symptom severity and recovery were examined using Spearman’s rank correlation coefficients with the Japanese versions of the Quick Inventory of Depressive Symptomatology (QIDS-J) and the Questionnaire about the Process of Recovery (QPR-J).

Of the 183 respondents (mean age 43.6 ± 12.4 years; 54.1% female), the mean QIDS-J score was 9.55 ± 5.25 and 60.7% were in remission. Fourteen of the 63 strategies were used by at least half of the participants. The most frequently used strategies were “ensure enough rest to avoid exhaustion through overexertion” (88.0%), “engage in leisure activities (e.g. reading, watching TV, cooking, traveling, and driving)” (78.9%), and “eat a healthy diet” (65.0%). The strategies rated most useful included “discuss information about depression with a therapist” (86.7%), “meet with friends with whom I can be myself” (83.5%), and “avoid or minimize contact with people who tend to make me stressed or depressed” (83.3%). Participants reported using an average of 20.8 ± 13.5 strategies, of which 13.1 ± 9.16 were rated as useful. The number of strategies rated as useful was weakly negatively correlated with the QIDS-J scores (Spearman’s ρ = −0.207, p = 0.006) and moderately positively correlated with the QPR-J scores (Spearman’s ρ = 0.472, p < 0.001).

The number of self-management strategies rated as useful showed a stronger correlation with personal recovery than with depressive symptom severity. The use of a greater number of self-management strategies may be associated with higher levels of personal recovery.