Over the last decades research on depression has expanded considerably. Improved classification (DSM-III-R) and psychometric testing (Hamilton rating scale, Zung scale, etc.) resulted in an increase in reliable epidemiological data. The latter confirm the importance of depression as a health problem: the prevalence of major depression is 6-10%, mounting to 25% when ‘minor syndromes’ are taken into account (a.o. Goldberg et al., 1980).
In addition to improved classification and psychometric evaluation of depressive phenomena, psychosocial determinants have also been studied from broad theoretical viewpoints. Distortions in cognition (Beck et al., 1979), negative attributional styles (Peterson & Seligman, 1984; Tennen et al., 1987), lack of social skills (Coyne, 1976, 1985) and inadequate stress appraisal and coping (Lazarus & Folkman, 1984) have been conceptualized as causal intrapsychic mechanisms in depression. From a social psychiatric viewpoint the interaction between life events and long-standing difficulties on the one and and vulnerability factors (e.g. lack of intimacy, young children at home) and protective factors (‘buffering social support’) on the other hand have strengthened the theoretical base for preventive and curative interventions (Brown et al., 1986, 1987; Lin et al., 1985; Holahan & Moos, 1987).
In spite of the many theoretical approaches research on depression suffers from methodological one-sidedness. In an overview of the broad field of depression research, some salient features can be observed. The designs are generally experimental or quasi-experimental with a paucity of naturalistic studies that take the influence of psychosocial contexts of daily life into account.