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Clinical and Psychosocial Origins of Chronic Depressive Episodes

I: A Community Survey

Published online by Cambridge University Press:  02 January 2018

George W. Brown  and
Patricia Moran
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Abstract

Background

We consider how far it is possible to predict a chronic course of a depressive disorder from psychosocial and clinical material available at the point of onset.

Method

A population survey found 404 working-class mothers living in an inner-city area of London. The majority were interviewed three times over a 3-year period.

Results

Chronicity (more than 12 months' duration) was strongly related to both childhood adversity (parental indifference, family violence or any sexual abuse) and current adult interpersonal difficulties. The lack of positive events during the course of the episode was also independently related to chronicity, but to a lesser degree. Clinical characteristics were relatively unimportant compared with psychosocial factors.

Conclusions

The childhood risk factors were particularly important (judged by a path analysis), and a challenge for future research will be to establish the intervening processes involved with this distal link.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 4 , October 1994 , pp. 447 - 456
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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References

1. While the life-table approach is preferable, the majority of studies reviewed here do not employ this technique. Nevertheless, in the light of our own findings, their results on one- and two-year outcome might well not differ significantly.Google Scholar

2. Although in principle the presence of multiple observations on some subjects may introduce statistical dependencies that undermine the results from this logistic regression, a direct test for the presence of such dependencies using an exact probability method revealed no evidence for these. Similar results were obtained when the logistic regression was limited to the first observation in each case.Google Scholar

3. Three with a chronic episode had a positive event and recovered soon afterwards, just outside the 12 months. These have been classed as without a positive event as the key interest here is to explain the persistence of depression.Google Scholar

4. References, author details, and dates of receipt and acceptance are given at the end of the following companion paper.Google Scholar

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