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J Affect Disord. 2003 Feb;73(3):245-52.

Severity of stressful life events in first and subsequent episodes of depression: the relevance of depressive subtype.

Author information

1
School of Psychiatry, University of New South Wales, Randwick and Mood Disorders Unit, Prince of Wales Hospital, Randwick NSW 2031, Australia. phil.mitchell@unsw.edu.au

Abstract

BACKGROUND:

Recent studies have reignited debate concerning the relationship between stressful life events and depressive subtypes, particularly in relation to first versus subsequent episodes.

AIMS:

To investigate the relationship between stressful life events and variably defined melancholic/non-melancholic depressive subtypes, and the import of such life events to first compared with subsequent episodes across those subtypes.

METHOD:

Acute and chronic stressful life events were rated in 270 patients with DSM-IV Major Depressive episodes who were allocated to melancholic and non-melancholic groups separately as defined by DSM-III-R, DSM-IV, the Newcastle criteria and the CORE system.

RESULTS:

Severe stressful life events (both acute and chronic)-as defined by DSM-III-R axis IV-were more likely to occur prior to first rather than subsequent episodes, particularly for those with non-melancholic depression.

LIMITATIONS:

Dependence or independence of life events was not assessed. Genetic vulnerability to depression was not determined. Life events in first and subsequent depressive episodes were compared cross-sectionally between groups, not prospectively in the same cohort of patients. There were no differences in the number of severe life events-as defined by clinician consensus-between the first and subsequent episodes.

CONCLUSIONS:

These findings are consistent with other studies in suggesting an enhanced sensitisation of depressed patients to subsequent episodes of depression, but suggest that any such phenomenon is specific to non-melancholic depression, in comparison to one key previous study.

PMID:
12547293
DOI:
10.1016/s0165-0327(01)00479-7
[Indexed for MEDLINE]

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