Evidence map›Paper›PMID 42518170›Full record

ArticleJournal of clinical psychology2026

When Being Social Is Costly: Empathy's Role for Risk States, Acute Symptoms, and Cumulative Disease Severity of Depression.

Dahna Choi, Paula L Usemann, Katharina Förster, Roland Zahn, Vincent Hammes, Frederike Stein, Florian Thomas-Odenthal, Lea Teutenberg, Kira Flinkenflügel, Julia Hubbert and 15 more

Abstract read
In one paragraph

Article in Journal of clinical psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Dahna ChoiInstitute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.ORCID 0009-0009-6372-4747
Paula L UsemannDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Katharina FörsterInstitute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.
Roland ZahnDepartment of Psychological Medicine, Centre for Affective Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
Vincent HammesDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Frederike SteinDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Florian Thomas-OdenthalDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Lea TeutenbergDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Kira FlinkenflügelInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Julia HubbertInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Christoph JurischkaInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Judith KriegerInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Elisabeth J LeehrInstitute for Translational Psychiatry, University of Münster, Münster, Germany.ORCID 0000-0002-9264-5003
Susanne MeinertInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Tim HahnInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Jonathan ReppleInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Nils OpelDepartment of Psychiatry & Neuroscience, Charité University Medicine Berlin, Berlin, Germany.
Hamidreza JamalabadiDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.ORCID 0000-0003-2485-2374
Andreas JansenDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Benjamin StraubeDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Igor NenadićDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.ORCID 0000-0002-0749-7473
Udo DannlowskiInstitute for Translational Psychiatry, University of Münster, Münster, Germany.
Tilo KircherDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Nina AlexanderDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany.
Philipp KanskeInstitute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.

Funding

Deutsche Forschungsgemeinschaft FOR2107 DA1151/10-1Deutsche Forschungsgemeinschaft FOR2107 DA1151/11-1Deutsche Forschungsgemeinschaft FOR2107 DA1151/5-1Deutsche Forschungsgemeinschaft FOR2107 DA1151/5-2Deutsche Forschungsgemeinschaft FOR2107 DA1151/9-1Deutsche Forschungsgemeinschaft FOR2107 KI588/14-1Deutsche Forschungsgemeinschaft FOR2107 KI588/14-2Deutsche Forschungsgemeinschaft FOR2107 KI588/20-1Deutsche Forschungsgemeinschaft FOR2107 KI588/22-1Deutsche Forschungsgemeinschaft FOR2107 STR1146/18-1Deutsche Forschungsgemeinschaft GRK2773/1- 454245598Deutsche Forschungsgemeinschaft SFB/TRR 393 521379614Else Kröner-Fresenius-Stiftung 2023_EKEA.153Innovative Medical Research (IMF) of the medical faculty of the University of Münster ME122205Innovative Medical Research (IMF) of the medical faculty of the University of MÜnster ME122205Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster Dan3/022/22Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of MÜnster Dan3/022/22LOEWE program of the Hessian Ministry of Science and Arts LOEWE1/16/519/03/09.001(0009)/98UK Medical Research Council MR/T017538/1UK Medical Research Council MR/Y008545/1
6 · The paper itself

Abstract

objectivesPatients with major depressive disorder (MDD) frequently report burdensome interpersonal difficulties and altered empathy and perspective-taking. Previous findings on binary comparisons between patients and healthy controls are limited in their clinical translation as they neglect dissociable risk and disease states. In this preregistered study (https://osf.io/k6mdh/overview?view_only=04b7f39f59a8434292cd472120f661ca), we extend case-control comparisons by additionally investigating empathic distress, empathic concern, and perspective-taking in association with (a) familial MDD risk, (b) acute symptom severity, and (c) cumulative MDD severity.

methodWe analyzed data from n = 499 MDD patients and n = 670 healthy controls from the Marburg-Münster-Affective-Cohort Study. Robust linear regressions were run to investigate group differences in self-reported empathy and perspective-taking and their associations with acute symptom severity and familial MDD risk. Analyses on cumulative MDD severity were run in a structural equation model.

resultsEmpathic distress was positively associated with both acute and cumulative MDD severity and was elevated in patients compared to healthy controls. A positive association between empathic distress and familial MDD risk became non-significant after adjustment for age and sex. Patients also reported higher levels of empathic concern-likely influenced by acute symptom severity-and slightly lower levels of perspective-taking.

conclusionsOur associational findings indicate empathic distress to constitute a correlate of acute MDD and longer-term MDD progression, while its relevance for MDD risk requires further investigation. We provide new indications of a generalized heightened emotional attunement during acute depression, entailing both empathic concern and empathic distress. Longitudinal studies are warranted to probe causal associations to prospectively inform psychotherapeutic interventions addressing maladaptive empathic processes.

Indexed as

EmpathyMajor Depressive DisorderAdultCase-Control StudiesFemaleHumansMaleMiddle AgedSeverity of Illness Indexempathic concernempathic distressmajor depressive disorderperspective‐takingsocial cognition

Identifiers

PMID42518170
PMCPMC13544485

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.