Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T11:13:23.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Social Factors and Comorbidity of Depressive and Anxiety Disorders

Published online by Cambridge University Press:  06 August 2018

G.W. Brown ,
T. O. Harris  and
M. J. Eales
G.W. Brown*
Affiliation:
Royal Holloway, University of London
T. O. Harris
Affiliation:
Royal Holloway, University of London
M. J. Eales
Affiliation:
Tone Vale Hospital, Norton Fitzwarren, Somerset, UK
*
Professor Brown, Department of Social Policy and Social Science, Royal Holloway, University of London, 11 Bedford Square, London WC1B 3RA
Get access Rights & Permissions [Opens in a new window]

Abstract

Differences in rates of depression across and between populations can be considerable and are largely determined by psychosocial factors. Such findings have important implications for comorbidity. On the basis of multiplying independent probabilities, the proportion of comorbid conditions increases as base rates of the disorders increase in a population. If such a chance combination has clinical implications, it would appear to be a “fact” of significance irrespective of biological underpinnings. In a recent survey of 404 women living with at least one child in an inner-city area, the rate of both anxiety and depression was highly related to the childhood experiences of neglect and abuse. However, adversity in adult life (e.g. widowhood or divorce), which might be expected to relate to current stressors, was only related to the rate of depression. The two risk factors had a considerable impact on comorbidity by increasing the rate of each disorder and thus the probability of their occurring together. They had a lesser impact as “common antecedents”. If both influences are considered, such adversity explains around half of the comorbidity. This is a conservative estimate of the impact of psychosocial factors.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 50 - 57
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Pschiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andrews, B. & Brown, G. W. (1988) Marital violence in the community. A biographical approach. British Journal of Psychiatry, 153, 305–312.CrossRefGoogle ScholarPubMed
Andrews, B., Brown, G. W. & Creasey, L. (1990) Intergenerational links between psychiatric disorder in mothers and daughters: the role of parenting experiences. Journal of Child Psychology and Psychiatry, 31, 1115–1129.CrossRefGoogle ScholarPubMed
Barlow, D. H. (1988) Anxiety and its Disorders. New York: Guilford Press.Google Scholar
Bifulco, A., Brown, G. W. & Harris, T. O. (1987) Childhood loss of parent, lack of adequate parental care and adult depression: a replication. Journal of Affective Disorders, 12, 115–128.CrossRefGoogle ScholarPubMed
Bifulco, A., Brown, G. W. & Adler, Z. (1991) Early sexual abuse and clinical depression in adult life. British Journal of Psychiatry, 159, 115–122.CrossRefGoogle ScholarPubMed
Bifulco, A., Brown, G. W. & Harris, T. O. (1994) Childhood Experience of Care and Abuse (CECA): a retrospective interview measure. Child Psychology and Psychiatry, 35, 1419–1435.CrossRefGoogle ScholarPubMed
Brown, G. W. (1989) Depression. In Life Events & Illness (eds Brown, G. W. & Harris, T. O.), pp. 49–93. New York: Guilford Press.Google ScholarPubMed
Brown, G. W. (1993) Life events and affective disorders: replications and limitations. Psychosomatic Medicine, 55, 248–259.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar
Brown, G. W. & Prudo, R. (1981) Psychiatric disorder in a rural and an urban population: 1. Aetiology of depression. Psychosocial Medicine, 11, 581–599.CrossRefGoogle Scholar
Brown, G. W., Craig, T. K. J. & Harris, T. O. (1985) Depression: disease or distress? Some epidemiological considerations. British Journal of Psychiatry, 147, 612–622.CrossRefGoogle ScholarPubMed
Brown, G. W., Andrews, B., Harris, T. O., et al (1986) Social support, self-esteem and depression. Psychological Medicine, 16, 813–831.Google ScholarPubMed
Brown, G. W. & Harris, T. O. (1986) Establishing causal links: The Bedford College studies of depression. In Life Events and Psychiatric Disorders: Controversial Issues (ed. Katschnig, H.), pp. 107–187. Cambridge: Cambridge University Press.Google Scholar
Brown, G. W., Adler, Z. & Bifulco, A. (1988) Life events, difficulties and recovery from chronic depression. British Journal of Psychiatry, 152, 487–498.Google ScholarPubMed
Brown, G. W., Bifulco, A. & Andrews, B. (1990a) Self-esteem and depression: 3. Aetiological issues. Social Psychiatry and Psychiatric Epidemiology, 25, 235–243.Google Scholar
Brown, G. W., Bifulco, A., Veiel, H., et al (1990b) Self-esteem and depression: 2. Social correlates of self-esteem. Social Psychiatry and Psychiatric Epidemiology, 25, 225–234.CrossRefGoogle Scholar
Brown, G. W., Andres, B., Bifulco, A., et al (1990c) Self-esteem and depression: 1. Measurement issues and prediction of onset. Social Psychiatry and Psychiatric Epidemiology, 25, 200–209.Google ScholarPubMed
Brown, G. W. & Harris, T. O. (1993) Aetiology of anxiety and depressive disorders in an inner-city population. 1. Early adversity. Psychological Medicine, 23, 143–154.Google Scholar
Brown, G. W., Harris, T. O. & Eales, K. J. (1993) Aetiology of anxiety and depressive disorders in an inner-city population. 2. Comorbidity and adversity. Psychological Medicine, 23, 155–165.CrossRefGoogle Scholar
Brown, G. W. & Moran, P. (1994) Clinical and psychosocial origins of chronic depressive episodes: 1. A community survey. British Journal of Psychiatry, 165, 447–456.CrossRefGoogle Scholar
Cooper, J. E., Copeland, J. R. M., Brown, G. W., et al (1977) Further studies on interviewer training and inter-rater reliability of the Present State Examination (PSE). Psychological Medicine, 7, 517–523.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
Eales, M. J. (1985) Social factors in the occurrence of depression, and allied disorders, in unemployed men. PhD thesis, Royal Holloway & Bedford New College (University of London).Google Scholar
Finlay-Jones, R. (1989) Anxiety. In Life Events and Illness, Vol. 1 (eds Brown, G. W. & Harris, T. O.), pp. 95–112. New York: Guilford Press.Google Scholar
Finlay-Jones, R., Brown, G. W., Duncan-Jones, P., et al (1980) Depression and anxiety in the community. Psychological Medicine, 10, 445–454.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Gaminde, I., Uria, M., Padro, D., et al (1993) Depression in three populations in the Basque country – a comparison with Britain. Social Psychiatry and Psychiatric Epidemiology, 28, 243–251.CrossRefGoogle 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.Google ScholarPubMed
Harris, T. O., Brown, G. W. & Bifulco, A. (1986) Loss of parent in childhood and adult psychiatric disorder: the Walthamstow Study. 1. The role of lack of adequate parental care. Psychological Medicine, 16, 641–659.CrossRefGoogle Scholar
Maser, J. D. & Cloninger, C. R. (1990) Comorbidity of Mood and Anxiety Disorders. Washington, DC: APP.Google Scholar
Prudo, R., Brown, G. W., Harris, T. O., et al (1981) Psychiatric disorder in a rural and an urban population: 2. Sensitivity to loss. Psychological Medicine, 11, 601–616.Google Scholar
Robins, L. N. & Regier, D. A. (1991) Psychiatric Disorders in America. New York: Free Press.Google Scholar
Spitzer, R. L., Endicott, J. & Robbins, E. (1977) Research Diagnostic Criteria for a Selected Group of Functional Disorders (3rd edn). New York: Biometrics Research Division, New York State Psychiatric Institute.Google Scholar
Straus, M., Gelles, R. & Steinmetz, S. (1980) Behind Closed Doors: Violence in the American Family. New York: Anchor.Google Scholar
Veiel, H. O. F. & Baumann, U. (1992) The Meaning and Measurement of Social Support. Washington, DC: Hemisphere Publishing Corporation.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the Present State Examination and CATEGO Programme. London: Cambridge University Press.Google Scholar
Wing, J. K. & Sturt, E. (1978) The PSE-ID-CATEGO System. Supplementary Manual. London: MRC Social Psychiatry Unit.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.