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In the Shadow of Adversity: the Evolution and Resolution of Anxiety and Depressive Disorder

Published online by Cambridge University Press:  02 January 2018

P. G. Surtees
P. G. Surtees*
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR
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Abstract

Background

It was proposed to explore the longitudinal relationship between adverse experience and mental health; in particular, whether particular adverse experiences influence the form of subsequent expression of morbidity.

Method

Three groups of women were selected: 64 whose marital partner had recently died, 143 whose husbands had recently experienced a myocardial infarction and a third group of 32 women who had sought protection in a Women's Aid refuge. An initial interview assessed psychiatric status according to the RDC for the six months before the event and up to the time of interview, and a second interview was completed four months after the event had occurred. The course was assessed using the Longitudinal Interval Follow-up Evaluation.

Results

For the coronary group, the prevalence of psychiatric disorder doubled following the experience of the event, and was most pronounced for anxiety disorder. For the bereaved, rates increased over eight times for major depressive disorder and more than twice for anxiety disorder, following the loss; for the refuge group, prevalence rates were lower after entering the refuge than those before. Analyses that took account of the timing of the onset of disorders showed that in almost half of those experienced by the coronary group, and about 40% of the bereaved group, onset pre-dated the timing of the event.

Conclusions

The results further advance knowledge of the evolution and form of psychiatric conditions following the experience of severe adversity.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 5 , May 1995 , pp. 583 - 594
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Brown, G. W. & Harris, T. O. (1989) Life Events and Illness. New York: Guildford.Google Scholar
Brown, G. W., Bifulco, A. & Andrews, B. (1990) Self-esteem and depression. IV. Effect on course and recovery. Social Psychiatry and Psychiatric Epidemiology, 25, 244–249.CrossRefGoogle ScholarPubMed
Brown, G. W., Lemyre, L. & Bifulco, A. (1992) Social factors and recovery from anxiety and depressive disorders. A test of specificity. British Journal of Psychiatry, 161, 44–54.CrossRefGoogle ScholarPubMed
Clayton, P. J. (1974) Mortality and morbidity in the first year of widowhood. Archives of General Psychiatry, 30, 747–750.CrossRefGoogle ScholarPubMed
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247–256.CrossRefGoogle Scholar
Feinstein, A. R. (1970) The pre-therapeutic classification of comorbidity in chronic disease. Journal of Chronic Diseases, 23, 455–468.Google Scholar
Finlay-Jones, R. & Brown, G. W. (1981) Types of stressful life event and the onset of anxiety and depressive disorders. Psychological Medicine, 11, 803–815.Google Scholar
Frank, E., Prien, R. F., Jarrett, R. B., et al (1991) Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851–855.Google Scholar
Goldberg, D., Bridges, K., Cook, D., et al (1990) The influence of social factors on common mental disorders: destabilisation and restitution. British Journal of Psychiatry, 156, 704–713.CrossRefGoogle ScholarPubMed
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders: a Bio-Social Model. London: Tavistock.Google Scholar
Jacobs, S. (1993) Pathologic Grief: Maladaptation to Loss. Washington, D.C.: American Psychiatric Press.Google Scholar
Jacobs, S., Hansen, F., Kasl, S., et al (1990) Anxiety disorders during acute bereavement: risk and risk factors. Journal of Clinical Psychiatry, 51, 269–274.Google ScholarPubMed
Keller, M. B., Lavori, P. W., Friedman, B., et al (1987) The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548.CrossRefGoogle ScholarPubMed
Kessler, R. C., McGonagle, K. A., Zhao, S., et al (1994) Lifetime and 12-month prevalence of DSM–III–R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.Google Scholar
Maser, J. D. & Cloninger, C. R. (1990) Comorbidity of Mood and Anxiety Disorders. Washington, DC: American Psychiatric Press.Google Scholar
Meltzer, H. (1993) The OPCS survey of psychiatric morbidity: rationale, purpose, design and procedures. World Psychiatric Association Symposium, Changing the Course and Outcome of Mental Disorder, Groningen, Netherlands, 1993.Google Scholar
Miller, P. McC., Dean, C., Ingham, J. G., et al (1986) Life events and long term difficulties in a sample of Edinburgh women with some reflections on the concept of independence. British Journal of Psychiatry, 148, 686–696.Google Scholar
Miller, P. McC., Ingham, J. G., Kreitman, N. B., et al (1987) Life events and other factors implicated in onset and in remission of psychiatric illness in women. Journal of Affective Disorders, 12, 73–88.CrossRefGoogle ScholarPubMed
Miller, P. McC. & Surtees, P. G. (1993) Partners in adversity: II. Measurement and description of stressful event sequences (‘Complexes$’). European Archives of Psychiatry and Clinical Neuroscience, 242, 233–239.Google Scholar
Osterweis, M., Solomon, F. & Green, M. (eds) (1985) Epidemiologic perspectives on the health consequences of bereavement. In Bereavement Reactions, Consequences, and Care, chap. 2. Washington, DC: National Academy Press.Google Scholar
Parkes, C. M. (1970) The first year of bereavement: a longitudinal study of the reaction of London widows to the death of their husbands. Psychiatry, 33, 444–467.Google Scholar
Parkes, C. M. (1986) Bereavement: Studies of Grief in Adult Life. London: Tavistock.Google Scholar
Parkes, C. M., Stevenson-Hinde, J. & Marris, P. (eds) (1993) Attachment Across the Life Cycle. London: Routledge.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Surtees, P. G. (1989) Adversity and psychiatric disorder: A decay model. In Life Events and Illness (eds G. W. Brown & T. O. Harris), pp. 161–195. New York: Guilford.Google Scholar
Surtees, P. G., Miller, P. McC., Ingham, J. G., et al (1986). Life events and the onset of affective disorder: a longitudinal general population study. Journal of Affective Disorders, 10, 37–50.CrossRefGoogle ScholarPubMed
Surtees, P. G. & Duffy, J. C. (1989) Binary and rate measures of life event experience: their association with illness onset in Edinburgh and London surveys. Journal of Affective Disorders, 16, 139–149.Google Scholar
Surtees, P. G. & Miller, P. McC. (1993) Partners in adversity: I. Study design and context. European Archives of Psychiatry and Clinical Neuroscience, 242, 224–232.Google Scholar
Surtees, P. G. & Barkley, C. (1994) Future imperfect: the long-term outcome of depression. British Journal of Psychiatry, 164, 327–341.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wortman, C. B., Silver, R. C. & Kessler, R. C. (1993) The meaning of loss and adjustment to bereavement. In Handbook of Bereavement; Theory, Research and Intervention (eds M. S. Stroebe, W. Stroebe & R. O. Hansson). Cambridge: Cambridge University Press.Google Scholar
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