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Clinical and Psychosocial Origins of Chronic Depressive Episodes

II: A Patient Enquiry

Published online by Cambridge University Press:  02 January 2018

George W. Brown ,
P. Moran ,
T. O. Harris ,
C. Hepworth  and
R. Robinson
George W. Brown*
Affiliation:
Royal Holloway College, London
P. Moran
Affiliation:
Royal Holloway College, London
T. O. Harris
Affiliation:
Royal Holloway College, London
C. Hepworth
Affiliation:
University of North London
R. Robinson
Affiliation:
Royal Holloway College, London
*
Professor George Brown, Department of Social Policy and Social Science, Royal Holloway College, University of London, 11 Bedford Square, London WC1B 3RA
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Abstract

Background

We consider how well the psychosocial and clinical factors found to predict a chronic course for depressive episodes in the community, held for female psychiatric patients.

Method

A consecutive series of depressed patients, aged 18 to 60, treated as in-patients, out-patients or day-patients at psychiatric departments of two London hospitals, were interviewed initially and at follow-up two years later.

Results

Indices of childhood adversity and current interpersonal difficulties predicted episodes taking a chronic course (of more than 12 months' duration). Half of the episodes associated with one or the other factor were chronic, compared with 22% of those with neither. The patients were at higher risk than the community series (75% v. 34%) and this explains their much greater rate of chronicity. There was also some evidence that social support reduced risk. Clinical features and the presence of a personality disorder were unrelated to chronicity.

Conclusions

Similar psychosocial factors are important for predicting chronicity in both community and patient series.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 4 , October 1994 , pp. 457 - 465
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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